Extracellular Vesicles to Predict Outcomes After Transcatheter Aortic Valve Implantation – a Prospective, Multicenter Cohort Study

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2024年5月28日

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Radosław Wilimski,
Jan Budzianowski,
Michał Łomiak,
Anna Olasińska-Wiśniewska,
Katarzyna Pieniak,
Szymon Jędrzejczyk,
Olaf Domaszk,
Magdalena Chudzik,
Krzysztof J. Filipiak,
Jarosław Hiczkiewicz,
Wojciech Faron,
Tomasz Urbanowicz,
Marek Jemielity,
Marek Grygier,
Marcin Grabowski,
Mariusz Kuśmierczyk,
Bartosz Rymuza,
Zenon Huczek,
Janusz Kochman,
Edwin van der Pol,
Rienk Nieuwland,
Aleksandra Gąsecka

摘要

Introduction

Transcatheter aortic valve implantation (TAVI) is an established treatment for aortic stenosis (AS) in patients at intermediate and high surgical risk. Circulating extracellular vesicles (EVs) are nanoparticles involved in cardiovascular diseases. We aimed to (i) determine the effect of TAVI on plasma concentrations of five EV subtypes and (ii) evaluate the predictive value of EVs for post-TAVI outcomes.

Methods

Blood samples were collected 1 day before TAVI and at hospital discharge. Concentrations of EVs were evaluated using flow cytometry.

Results

Concentration of leukocytes EVs decreased after TAVI, compared to the measurement before (p = 0.008). Among 123 patients discharged from the hospital, 19.5% experienced MACCE during the median of 10.3 months. Increased pre-TAVI concentration of phosphatidylserine-exposing EVs was an independent predictor of MACCE in multivariable analysis (OR 5.313, 95% CI 1.164–24.258, p = 0.031).

Conclusions

Patients with increased pre-TAVI concentration of procoagulant, PS-exposing EVs have over fivefold higher odds of adverse outcomes.

Graphical Abstract