IMR Press / RCM / Volume 20 / Issue 3 / DOI: 10.31083/j.rcm.2019.03.524
Open Access Systematic Review
Serum albumin in patients undergoing transcatheter aortic valve replacement: A meta-analysis
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1 First Faculty of Medicine, Charles University, Prague, 1200, Czech Republic
2 2nd Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, 1200, Czech Republic
3 Department of Cardiac and Thoracic Vascular Surgery, University of Schleswig-Holstein, Lübeck Campus, Lübeck, 23562, Germany
4 Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 45229, USA
5 Department of Thoracic and Cardiovascular Surgery, Research Institute, Cleveland Clinic, Cleveland, Ohio, 44195, USA
6 Department of Cardiology and Cardiac Surgery, Institute of Clinical and Experimental Medicine IKEM, Prague, 14021, Czech Republic
*Correspondence: dr.hsieh520@gmail.com (Wan Chin Hsieh)
Rev. Cardiovasc. Med. 2019, 20(3), 161–169; https://doi.org/10.31083/j.rcm.2019.03.524
Submitted: 7 July 2019 | Accepted: 19 August 2019 | Published: 30 September 2019
Copyright: © 2019 Hsieh et al. Published by IMR press.
This is an open access article under the CC BY-NC 4.0 license https://creativecommons.org/licenses/by/4.0/.
Abstract

Transcatheter aortic valve replacement is becoming a more common therapeutic option for the treatment of aortic stenosis in patients at high risk for invasive surgery, but detecting which patients will benefit clinically can be challenging. Hypoalbuminemia is a useful prognostic marker for chronic inflammation in this population. We carried out a systematic review and meta-analysis of studies evaluating the prognostic value of serum albumin level in patients undergoing transcatheter aortic valve replacement. A literature search of PubMed, Embase, ScienceDirect, Web of Science, SciELO, BIOSIS, Wanfang, and CNKI databases was conducted. Articles published between January 2000 and December 2017 reporting on the prognostic value of low levels of serum albumin in patients undergoing transcatheter aortic valve replacement were analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. 11 studies including 6456 patients met inclusion criteria for meta-analysis. A lower serum albumin level was associated with a lower survival rate at follow-up in patients who underwent transcatheter aortic valve replacement. A sub-group analysis of eight studies reporting adjusted hazard ratios indicated that low serum albumin was independently correlated with increased post-operative mortality. The hazard ratio of mortality risk associated with each 1 g/dL increment in serum albumin level was 0.46, suggesting a potential dose-response relationship between increased serum albumin level and increased survival rate in patients undergoing transcatheter aortic valve replacement. This meta-analysis provides strong evidence for the utility of serum albumin as a prognostic marker in aortic stenosis patients undergoing transcatheter aortic valve replacement, with low serum albumin levels (2.5-3.5 g/dL) suggesting poor prognosis.

Keywords
Albumin
transcatheter aortic valve replacement
mortality
meta-analysis
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