Neutrophil-to-lymphocyte ratio as a predictor of inflammatory response in patients with acute kidney injury after transcatheter aortic valve implantation.

Background: Persistent inflammatory response after transcatheter aortic valve implantation (TAVI) is one of the possible causes of early and mid-term postprocedural adverse events.

Objectives: To establish the predictive role of whole blood parameters on inflammatory response characteristics within a 1-year follow-up.

Material And Methods: The study group comprised 163 consecutive patients (52.1% females), mean age 78.6 (±6.6) years (± standard deviation (SD)) who underwent TAVI and completed 1-year follow-up on-site examinations. Patients were retrospectively divided into acute kidney injury (AKI) and non-AKI subgroups. Clinical and laboratory data were collected. In-hospital and follow-up outcomes were assessed.

Results: The clinical and procedural details did not show significant differences between AKI and non-AKI groups. Neutrophil-to-lymphocyte ratio (NLR) decreased from baseline to measurement after 1 year with a statistically significant decline in the whole study population and non-AKI subgroup (both p = 0.005). The baseline NLR cutoff value of 4.2 for the non-AKI group ((area under the curve (AUC) = 0.718, p < 0.0001; sensitivity 46.27%, specificity 92.31%) and of 3.8 for the AKI group (AUC = 0.673, p = 0.0174; sensitivity 59.25%, specificity 84%) had prognostic properties for persistent NLR elevation.

Conclusions: The NLR decreases after TAVI, and this phenomenon is more evident in patients without AKI. Furthermore, baseline NLR cutoff values may be considered predictors of persistence of inflammatory response.