Author + information
- Noriaki Tabata, MDa,b,
- Baravan Al-Kassou, MDa,
- Atsushi Sugiura, MDa,
- Jasmin Shamekhi, MDa,
- Hendrik Treede, MDc,
- Masanobu Ishii, MD, MPHb,
- Kenichi Tsujita, MDb,
- Nikos Werner, MDa,
- Eberhard Grube, MDa,
- Georg Nickenig, MDa and
- Jan-Malte Sinning, MDa,∗ (, )@norcello0528@sinning_jan
- aDepartment of Medicine II, Heart Center Bonn, University Hospital Bonn, Germany
- bDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- cDepartment of Cardiothoracic Surgery, Heart Center Bonn, University Hospital Bonn, Germany
- ↵∗Address for correspondence:
Dr. Jan-Malte Sinning, Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
Objectives The purpose of this study is to investigate the predictive value of the platelet-to-lymphocyte ratio (PLR)in cancer patients undergoing transcatheter aortic valve replacement (TAVR).
Background The PLR is a promising marker to predict clinical outcomes in various cancer types as well as in cardiovascular disease.
Methods Consecutive TAVR patients were enrolled in the study. We stratified patients into 2 groups: cancer and noncancer. Baseline complete blood counts with a differential hemogram were collected before TAVR. The primary outcome was all-cause death within a 3-year follow-up.
Results In total, 240 of 1,204 patients (19.9%) had a cancer history. Cancer patients had a significantly higher baseline PLR than noncancer patients (median [interquartile range], 159.8 [109.6 to 244.6] vs. 150.3 [108.7 to 209.0]; p = 0.024). Kaplan-Meier analysis revealed that cancer patients had worse outcomes than noncancer patients (log-rank p < 0.001). Patients who died had a significantly higher baseline PLR than those who survived both in the cancer (p = 0.009) and noncancer (p = 0.027) groups. Multivariable analyses showed that the PLR (by 100 increase) was an independent predictor of adverse outcomes in both cancer (hazard ratio: 1.07; 95% confidence interval: 1.02 to 1.13; p = 0.006) and noncancer (hazard ratio: 1.20; 95% confidence interval: 1.06 to 1.36; p = 0.004). The highest mortality was observed for patients with cancer and increased PLR (above the median) (log-rank p < 0.001).
Conclusions Cancer patients undergoing TAVR had a significantly higher PLR than those without cancer. Higher PLR was associated with a worse outcome following TAVR.
- aortic stenosis
- cancer survivorship
- transcatheter aortic valve replacement
- valvular disease
Dr. Tabata was supported financially in part by a fellowship from the Astellas Foundation for Research on Metabolic Disorders and the Uehara Memorial Foundation. Drs. Sinning, Werner, and Nickenig have received speaker honoraria and research grants from Abbott, Abiomed, Medtronic, Boston Scientific, and Edwards Lifesciences. Dr. Tsujita has received grants from Abbott Vascular Japan, Medtronic Japan, and Boston Scientific Japan. All other author have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received July 10, 2019.
- Revision received October 2, 2019.
- Accepted October 7, 2019.
- 2019 The Authors