Effect on Mortality of Systemic Thrombo-Inflammatory Response after Transcatheter Aortic Valve Implantation

Abstract After transcatheter aortic valve implantation (TAVI) there is consistently identified fall in platelets accompanied by a leucocyte (WBC) increase. We aimed to analyze the prognostic value of early platelet and WBC count changes (thrombo-inflammatory response) after successful TAVI. Among 432 consecutive patients [median 83.0 years of age, 63.4% female], platelets and WBCs were measured prior to and for 7 days post-TAVI. Follow-up was 36.9 (21.4-48.0) months. Platelet drop (∆%Platelet-max) and parallel WBC rise (∆%WBC-max) were seen at days 1-3. Both ∆%Platelet-max≤-37.6% and ∆%WBC-max>72.5% predicted mortality (AUC=0.569 and AUC=0.626). The 30-day and 1-year mortality (13.1% and 26.2%) were highest among 28% patients with a greater drop in platelets and a greater increase in WBCs; intermediate (0.9% and 12.3%) among 52.5% patients with either a greater drop in platelets or a greater increase in WBCs, but not both; and lowest (0% and 6.6%) among 19.5% patients with a lesser drop in platelets and a lesser increase in WBCs (p