The predictive value of neutrophil to lymphocyte ratio and mean platelet volume on acute kidney injury after TAVI

Abstract

Objective: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Acute kidney injury (AKI) is a common complication after TAVI. The development of AKI after TAVI has been linked to the thromboinflammatory response as evaluated by the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV). We sought to determine the predictive value of NLR and MPV on AKI after TAVI in this study. Method: This is a single-center retrospective study. Baseline, peri-procedural, and post-procedural demographic, laboratory, and clinical characteristics were assessed for AKI. The optimal NLR and MPV cut-off values for predicting AKI were determined using receiver operating characteristic (ROC) curve analysis. Results: A total of 184 consecutive patients (age 79.4 ± 7.8 years, 61.4% female) who underwent TAVI were included in this study. The optimal cut-off points for the NLR and MPV were 5.70 (AUC: 0.790; 95% CI: 0.711-0.869, p<0.001 and sensitivity= 80.0%, specificity= 65.2%) and 9.15 fL (AUC:0.713; 95% CI: 0.629-0.997, p<0.001 and sensitivity=70.7%, specificity=63.6%), respectively. AKI occurred in 41 (22.3%) patients included in the study and 6 (3.3%) required dialysis. Baseline GFR (OR: 0.98; 95% CI: 0.94-0.99, p = 0.001), post-procedural WBC count (OR: 1.17; 95% CI: 1.03-1.33, p= 0.02), post-procedural NLR≥ 5.7 (OR: 5.16; 95% CI: 1.84-14.48, p= 0.002), and post-procedural MPV ≥ 9.15 fL (OR: 3.70; 95% CI: 1.54–8.91, p= 0.004) were found to be the independent predictors of AKI after TAVI in multivariable analysis. Conclusion: Post-procedural NLR and MPV were found to be independent predictors of AKI after TAVI.