C-Reactive Protein to Albumin Ratio offers superior risk prediction in patients undergoing mitral valve edge-to-edge repair: a comparison to established surgical risk scores

Abstract Background The population of patients with relevant mitral regurgitation (MR) who stand to gain optimal benefit from valve transcatheter edge-to-edge repair (TEER) remains be determined. Prior TEER, a heart-team approach interdisciplinary decision-making is mandatory integrating both the patient profile and co-morbidities. In addition, application established surgical risk scores recommended by current guidelines. Whether alternative prediction more suitable for this fragile cohort burdened various co-morbidities has not been examined in detail. A simplified may achieved using C-Reactive Protein Albumin Ratio (CAR), but its value TEER unclear. Methods This single-center, retrospective study thought determine long-term prognostic accuracy different MR undergoing TEER. For analysis, 316 median follow-up time 5.81 years were included. primary outcome measure was defined as all-cause mortality. ROC analysis conducted identification CAR threshold, subsequently dichotomizing into two groups (CAR ≤0.4 >0.4) estimating their event rate Kaplan-Meier method. we evaluated compared conventional (logistic EuroSCORE Society Thoracic Surgeons [STS] score) C-Index analysis. Results Among high-risk (mean age 75.6±8.2 years, 61.7% male, logistic 19.9% [11.7; 31.6], STS Score 3.8% [2.2; 5.7]), 176 (55.7%) had ≤0.4. Patients an elevated (>0.4) predominantly suffered higher burden co-morbidities, such peripheral artery disease (p=0.001), chronic obstructive pulmonary (p=0.044), kidney (p=0.015). Consequently, these significantly than p=0.002; p<0.001). Stratification according threshold 0.4 led significant differences Cumulative Incidence curves (p<0.001). log-rank test revealed superior stratification (Figure 1). effect consequently reflects adjusted (0.608) (0.502; p<0.001) (0.498; Conclusions Our data provide first evidence that allows feasible easy-to-use real-word presenting advanced age, high proportion frailty numerous Alternative should investigated detail seem demonstrate limited applicability scheduled Funding Acknowledgement Type funding sources: Public Institution(s). Main source(s): University Medical Center Hamburg-Eppendorf, Hamburg, Germany