RESUMEN
OBJECTIVE: Aortic valve stenosis is a common valve disease in developed countries where the elderly population is high. Aortic valve stenosis is not a simple calcification; it is a dynamic process in which uric acid plays a serious role. We investigated the role of the serum uric acid/creatinine (SUA/Cr) ratio, which is an indicator of uric acid level independent of renal function, in determining the prognosis in patients who had undergone transcatheter aortic valve implantation (TAVI). PATIENTS AND METHODS: In this retrospective cohort study, 357 patients who underwent TAVI for symptomatic severe aortic stenosis between March 2019 and March 2022 were retrospectively analyzed. After applying exclusion criteria, the remaining 269 patients were included in the study. According to the Valve Academic Research Consortium criteria, major adverse cardiac and cerebrovascular events (MACCE) defined the endpoint of the study. Therefore, patients were divided into two groups: the MACCE group and the no MACCE group. RESULTS: Serum uric acid level was significantly higher in the MACCE group (7.0 ± 2.6) than in the no MACCE group (6.0 ± 1.7) (p = 0.008). SUA/Cr ratio was significantly higher in the MACCE group (6.7 ± 2.3) than in the no MACCE group (5.9 ± 1.1) (p = 0.007). CONCLUSIONS: The serum UA/creatinine ratio is important in determining the prognosis of patients undergoing TAVI.
Asunto(s)
Estenosis de la Válvula Aórtica , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Anciano , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Ácido Úrico , Estudios Retrospectivos , Creatinina , Resultado del Tratamiento , Pronóstico , Estenosis de la Válvula Aórtica/diagnóstico , Estenosis de la Válvula Aórtica/cirugía , Válvula Aórtica , Factores de RiesgoRESUMEN
OBJECTIVE: There has been an increase in the number of percutaneous coronary intervention (PCI) procedures performed in octogenarian patients due to increased life expectancy and developments in modern medicine. Frailty is associated with the aging process, gradual loss of multiple body functions, and poor health outcomes. We examined the association between frailty and major bleeding in octogenarian patients undergoing PCI. PATIENTS AND METHODS: We retrospectively analyzed the records of two local research hospitals in Turkey. In total, 244 patients were enrolled in this study. Patients were divided into two groups based on their Clinical Frailty Scale (CFS) score. The non-frail group included patients with CFS scores of 1 (very fit) to 4 (living with very mild frailty), while the frail group included those with CFS scores of 5 (living with mild frailty) to 9 (terminally ill). RESULTS: Of the 244 patients, 131 were classified into the non-frail group and 113 into the frail group. Ticagrelor use was significantly more common in the non-frail group (31.3% vs. 20.4%, p=0.036). Major bleeding was more common in the frail than non-frail group (20.4% vs. 6.1%, p<0.001). The rates of stroke and all-cause death were higher in the frail than in non-frail group (stroke 15.9% vs. 3.8%, p<0.001, as well as all-cause mortality rate (27.4% vs. 2.3%, p<0.001). CONCLUSIONS: Frailty is an independent predictor of major bleeding in patients undergoing PCI for acute coronary syndrome. Use of the P2Y12 inhibitor ticagrelor increases the risk of major bleeding in frail patients.