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Background <p>Transcatheter tricuspid valve repair (TTVr) is a treatment option for tricuspid regurgitation (TR) in patients with high surgical risk. Given the heterogeneity in clinical benefit, there is a need for markers to assess mortality risk in patients undergoing TTVr. The C-reactive protein (CRP)/albumin ratio (CAR) is a marker of systemic inflammation and reduced nutritional status, which can both occur in TR.</p> Methods <p>Consecutive patients undergoing TTVr at a tertiary care center were retrospectively analyzed. Serum CRP and albumin were collected at baseline. Intraprocedural success (IS) was defined according to TVARC criteria. The primary outcome of all-cause mortality was assessed up to 2&#xa0;years after TTVr.</p> Results <p>A total of 215 patients (69% females, median age 80&#xa0;years) were identified. IS was achieved in 61% of patients. AUC of CAR for 2-year mortality was 0.695, with an optimal threshold of 1.2945 (Youden index) dividing patients in high CAR (<i>n</i> = 93) and low CAR (<i>n</i> = 122) groups. In the high CAR group, the primary endpoint occurred more frequently (43% vs 15%, <i>p</i> &lt; 0.001) and significantly higher right atrial pressure, worse renal function, and less IS during TTVr were observed. High CAR was independently associated with an increased mortality risk even when adjusted for renal and liver function, right-ventricular function, and procedural failure (HR 2.188; 95%CI 1.2–3.9; <i>p</i> = 0.011).</p> Conclusion <p>Higher CAR reflects patients with advanced right-heart failure and extracardiac organ damage and is associated with mortality after TTVr. CAR is derived from readily available parameters and may be useful additive to established risk scores.</p> Graphical Abstract <p></p>

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C-reactive protein-to-albumin ratio is associated with mortality after transcatheter tricuspid valve repair

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月10日

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  • Karl Finke,
  • Laura Marx,
  • Jan Althoff,
  • Thorsten Gietzen,
  • Matthieu Schäfer,
  • Jan Wrobel,
  • Philipp von Stein,
  • Jennifer von Stein,
  • Maria Isabel Körber,
  • Stephan Baldus,
  • Roman Pfister,
  • Christos Iliadis

摘要

Background

Transcatheter tricuspid valve repair (TTVr) is a treatment option for tricuspid regurgitation (TR) in patients with high surgical risk. Given the heterogeneity in clinical benefit, there is a need for markers to assess mortality risk in patients undergoing TTVr. The C-reactive protein (CRP)/albumin ratio (CAR) is a marker of systemic inflammation and reduced nutritional status, which can both occur in TR.

Methods

Consecutive patients undergoing TTVr at a tertiary care center were retrospectively analyzed. Serum CRP and albumin were collected at baseline. Intraprocedural success (IS) was defined according to TVARC criteria. The primary outcome of all-cause mortality was assessed up to 2 years after TTVr.

Results

A total of 215 patients (69% females, median age 80 years) were identified. IS was achieved in 61% of patients. AUC of CAR for 2-year mortality was 0.695, with an optimal threshold of 1.2945 (Youden index) dividing patients in high CAR (n = 93) and low CAR (n = 122) groups. In the high CAR group, the primary endpoint occurred more frequently (43% vs 15%, p < 0.001) and significantly higher right atrial pressure, worse renal function, and less IS during TTVr were observed. High CAR was independently associated with an increased mortality risk even when adjusted for renal and liver function, right-ventricular function, and procedural failure (HR 2.188; 95%CI 1.2–3.9; p = 0.011).

Conclusion

Higher CAR reflects patients with advanced right-heart failure and extracardiac organ damage and is associated with mortality after TTVr. CAR is derived from readily available parameters and may be useful additive to established risk scores.

Graphical Abstract