Impact of cancer history on clinical outcome in patients undergoing transcatheter edge-to-edge mitral repair

• Published in: Clinical research in cardiology Vol. 110; no. 3; pp. 440 - 450
• Main Authors: Tabata, Noriaki, Weber, Marcel, Sugiura, Atsushi, Öztürk, Can, Tsujita, Kenichi, Nickenig, Georg, Sinning, Jan-Malte
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2021; Springer Nature B.V
• Subjects: Cancer; Cardiology; Clinical outcomes; Heart valves; Inflammation; Leukocytes (neutrophilic); Lymphocytes; Medicine; Medicine & Public Health; Mitral valve; Mortality; Neutrophils; Original Paper; Parameters; Platelets; Prognosis; Regurgitation; Repair; Mitral regurgitation; Biomarkers; Inflammation; Cancer
• ISSN: 1861-0684; 1861-0692
• DOI: 10.1007/s00392-020-01770-2

Background Little is known about the prevalence of a history of cancer and its impact on clinical outcome in mitral regurgitation (MR) patients undergoing transcatheter mitral valve repair (TMVR). Objectives The purpose of this study is to investigate the prevalence of cancer, baseline inflammatory parameters, and clinical outcome in MR patients undergoing TMVR. Methods Consecutive patients undergoing a MitraClip procedure were enrolled, and the patients were stratified into two groups: cancer and non-cancer. Baseline complete blood counts (CBC) with differential hemograms were collected prior to the procedure to calculate the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). All-cause death within a one-year was examined. Results In total, 82 out of 446 patients (18.4%) had a history of cancer. Cancer patients had a significantly higher baseline PLR [181.4 (121.1–263.9) vs. 155.4 (109.4–210.4); P  = 0.012] and NLR [5.4 (3.5–8.3) vs. 4.0 (2.9–6.1); P  = 0.002] than non-cancer patients. A Kaplan–Meier analysis revealed that cancer patients had a significantly worse prognosis than non-cancer (estimated 1-year mortality, 20.2 vs. 9.2%; log-rank P  = 0.009), and multivariable analyses of three models showed that cancer history was an independent factor for 1-year mortality. Patients who died during follow-up had a significantly higher baseline PLR [214.2 (124.2–296.7) vs. 156.3 (110.2–212.1); P  = 0.007] and NLR [6.4 (4.2–12.5) vs. 4.0 (2.9–6.2); P  < 0.001] than survivors. Conclusions In MitraClip patients, a history of cancer was associated with higher inflammatory parameters and worse prognosis compared to non-cancer patients. Graphical Abstract Central Illustration. Clinical outcomes and baseline PLR and NLR values accord-ing to one-year mortality. (Left) Patients who died within the follow-up period had a significantly higher baseline PLR (214.2 [124.2–296.7] vs 156.3 [110.2–212.1]; P = 0.007) and NLR (6.4 [4.2–12.5] vs 4.0 [2.9–6.2]; P < 0.001) than patients who survived. PLR, platelet-to-lymphocyte ratio; NLR, neutrophil-to-lymphocyte ratio (Right) A Kaplan-Meier analysis revealed that cancer patients had a significantly worse prognosis than non-cancer patients (estimated one-year mortality, 20.2 vs 9.2%; log-rank P = 0.009).