Correlation between staging classification of aortic stenosis based on the extent of cardiac damage and platelet indices.

Humans Aortic Valve Stenosis / blood Female Male Aged Aged, 80 and over Severity of Illness Index Blood Platelets / pathology Mean Platelet Volume Prospective Studies Predictive Value of Tests Transcatheter Aortic Valve Replacement / adverse effects Platelet Count Treatment Outcome Aortic Valve / diagnostic imaging Risk Factors
Aortic stenosis IPF MPV TAVI

Journal

BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539

Informations de publication

Date de publication:
14 Oct 2024
Historique:
received: 30 06 2024
accepted: 09 10 2024
medline: 15 10 2024
pubmed: 15 10 2024
entrez: 14 10 2024
Statut: epublish

Résumé

Platelets play a key role in the natural history of aortic stenosis (AS) and after transcatheter aortic valve implantation (TAVI). An echo-based staging system stratifies patients with severe AS into 5 groups according to the associated cardiac damage phenotype. We aimed to correlate these AS stages with platelet indices in post-TAVI patients. Patients with severe AS who underwent TAVI and were admitted to intensive cardiac care unit (ICCU) were prospectively identified and divided into 5 groups according to extra-valvular cardiac damage [no extravalvular cardiac damage (Stage 0), left ventricular damage (Stage 1), left atrial or mitral valve damage (Stage 2), pulmonary vasculature or tricuspid valve damage (Stage 3), or right ventricular damage (Stage 4)]. Baseline characteristics and complete blood count including mean platelet volume (MPV) and immature platelet fraction (IPF) were collected within 2 h after the procedure and analyzed in relation to aortic stenosis staging. A total of 220 patients were included. The mean age was 81 years old and 112 (50.9%) were female. Two (1%) patients were classified in stage 0; 34 (15%) in stage 1; 48 (22%) in stage 2; 49 (22%) in stage 3 and 87 (40%) in stage 4. Higher mean MPV values were correlated with higher AS staging (10.8 fL, 11 fL, 11.3 fL and 10.8 fL in stages 1, 2, 3 and 4, respectively, P = 0.02) as well as lower hemoglobin values (12 mg/dl, 11.6 mg/dl, 11 mg/dl and 11.3 mg/dl in stages 1, 2, 3 and 4, respectively P = 0.04). Mean IPF values were 5.3%, 5.58%, 5.57% and 4.83% in stage 1, 2, 3 and 4, respectively (P = 0.4). In a multivariate logistic regression model only MPV (OR = 2.6, P = 0.03) and body mass index (BMI) (OR = 1.17, P = 0.004) were correlated with higher staging (0-3) of AS. Although IPF and MPV levels increased in stages 0-3, there was a decrease in indices in stage 4, (probably due to bone marrow dysfunction) in this end-stage population. Higher levels of MPV and lower levels of hemoglobin were independently correlated with higher stages (0-3) of AS.

Sections du résumé

BACKGROUND BACKGROUND
Platelets play a key role in the natural history of aortic stenosis (AS) and after transcatheter aortic valve implantation (TAVI). An echo-based staging system stratifies patients with severe AS into 5 groups according to the associated cardiac damage phenotype. We aimed to correlate these AS stages with platelet indices in post-TAVI patients.
METHODS METHODS
Patients with severe AS who underwent TAVI and were admitted to intensive cardiac care unit (ICCU) were prospectively identified and divided into 5 groups according to extra-valvular cardiac damage [no extravalvular cardiac damage (Stage 0), left ventricular damage (Stage 1), left atrial or mitral valve damage (Stage 2), pulmonary vasculature or tricuspid valve damage (Stage 3), or right ventricular damage (Stage 4)]. Baseline characteristics and complete blood count including mean platelet volume (MPV) and immature platelet fraction (IPF) were collected within 2 h after the procedure and analyzed in relation to aortic stenosis staging.
RESULTS RESULTS
A total of 220 patients were included. The mean age was 81 years old and 112 (50.9%) were female. Two (1%) patients were classified in stage 0; 34 (15%) in stage 1; 48 (22%) in stage 2; 49 (22%) in stage 3 and 87 (40%) in stage 4. Higher mean MPV values were correlated with higher AS staging (10.8 fL, 11 fL, 11.3 fL and 10.8 fL in stages 1, 2, 3 and 4, respectively, P = 0.02) as well as lower hemoglobin values (12 mg/dl, 11.6 mg/dl, 11 mg/dl and 11.3 mg/dl in stages 1, 2, 3 and 4, respectively P = 0.04). Mean IPF values were 5.3%, 5.58%, 5.57% and 4.83% in stage 1, 2, 3 and 4, respectively (P = 0.4). In a multivariate logistic regression model only MPV (OR = 2.6, P = 0.03) and body mass index (BMI) (OR = 1.17, P = 0.004) were correlated with higher staging (0-3) of AS.
CONCLUSIONS CONCLUSIONS
Although IPF and MPV levels increased in stages 0-3, there was a decrease in indices in stage 4, (probably due to bone marrow dysfunction) in this end-stage population. Higher levels of MPV and lower levels of hemoglobin were independently correlated with higher stages (0-3) of AS.

Identifiants

DOI: 10.1186/s12872-024-04246-7 PMID: 39402456
pubmed: 39402456
doi: 10.1186/s12872-024-04246-7
pii: 10.1186/s12872-024-04246-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

555

Informations de copyright

© 2024. The Author(s).

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Auteurs

Tomer Maller (T)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Sharon Bruoha (S)

Department of Cardiology, Barzilai Medical Center, Ashkelon and Ben-Gurion University of the Negev, Ashkelon, Israel.

Ranel Loutati (R)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Shemy Carasso (S)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Louay Taha (L)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Pierre Sabouret (P)

ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France.
National College of French Cardiologists, 13 Rue Niepce, Paris, 75014, France.

Mattia Galli (M)

Maria Cecilia Hospital, GVM Care & Research, Cotignola, 48033, Italy.

Giuseppe Biondi Zoccai (GB)

Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, 00185, Italy.
Mediterranea Cardiocentro, Naples, 80122, Italy.

Luigi Spadafora (L)

Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Rome and Sapienza University of Rome, Rome, 00185, Italy.

Danny Dvir (D)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Mony Shuvy (M)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Rami Jubeh (R)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

David Marmor (D)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Nimrod Perel (N)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Nir Levi (N)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Itshak Amsalem (I)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Rafael Hitter (R)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Maayan Shrem (M)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Michael Glikson (M)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Elad Asher (E)

Jesselson Integrated Heart Center, Shaare Zedek Medical Center Jerusalem and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. el.asher@gmail.com.

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