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000267507 1001_ $$00000-0003-2967-6613$$aAl-Kassou, Baravan$$b0
000267507 245__ $$aCholesterol Crystal Dissolution Rate of Serum Predicts Outcomes in Patients With Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement.
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000267507 520__ $$aAortic stenosis has pathophysiological similarities with atherosclerosis, including the deposition of cholesterol-containing lipoproteins. The resulting cholesterol crystals activate the NLRP3 (NOD-like receptor protein 3) inflammasome, leading to inflammation and cardiovascular diseases. We aimed to investigate the cholesterol crystal dissolution rate (CCDR) of serum in patients with aortic stenosis and to assess the prognostic value of this biomarker.The study included 348 patients with aortic stenosis undergoing transcatheter aortic valve replacement. The CCDR was measured using flow cytometry to enumerate cholesterol crystals that were added to a serum solution, at baseline and after 2 hours of incubation. Based on the median CCDR, the cohort was stratified into high and low cholesterol crystal dissolvers. The incidence of the primary end point, a composite of 1-year all-cause mortality and major vascular complication, was significantly lower in the high CCDR group (7.3 per 100 person-years) compared with the low CCDR group (17.0 per 100 person-years, P=0.01). This was mainly driven by a lower 1-year mortality rate in patients with a high CCDR (7.3 versus 15.1 per 100 person-years, P=0.04). Unplanned endovascular interventions were significantly less frequent in high cholesterol crystal dissolvers (12.8 versus 22.6 per 100 person-years, P=0.04). Although low-density lipoprotein cholesterol levels were comparable in both groups (101.8±37.3 mg/dL versus 97.9±37.6 mg/dL, P=0.35), only patients with a low CCDR showed a benefit from statin treatment. In multivariate analysis, low CCDR (hazard ratio, 2.21 [95% CI, 0.99-4.92], P=0.04) was significantly associated with 1-year mortality.The CCDR is a novel biomarker associated with outcome in patients with aortic stenosis undergoing transcatheter aortic valve replacement. It may provide new insights into patients' anti-inflammatory capacity and additional prognostic information beyond classic risk assessment.
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000267507 650_7 $$2Other$$aTAVR
000267507 650_7 $$2Other$$acalcific aortic stenosis
000267507 650_7 $$2Other$$acholesterol crystal dissolution rate
000267507 650_7 $$2Other$$acholesterol crystals
000267507 650_7 $$2NLM Chemicals$$aBiomarkers
000267507 650_2 $$2MeSH$$aHumans
000267507 650_2 $$2MeSH$$aTranscatheter Aortic Valve Replacement
000267507 650_2 $$2MeSH$$aTreatment Outcome
000267507 650_2 $$2MeSH$$aAortic Valve Stenosis
000267507 650_2 $$2MeSH$$aRisk Assessment
000267507 650_2 $$2MeSH$$aBiomarkers
000267507 650_2 $$2MeSH$$aAortic Valve: surgery
000267507 650_2 $$2MeSH$$aRisk Factors
000267507 7001_ $$aAl-Kassou, Lara$$b1
000267507 7001_ $$aMahn, Thorsten$$b2
000267507 7001_ $$00000-0002-7941-8308$$aLütjohann, Dieter$$b3
000267507 7001_ $$00000-0002-5724-9814$$aShamekhi, Jasmin$$b4
000267507 7001_ $$00009-0001-0579-0844$$aWillemsen, Nicola$$b5
000267507 7001_ $$aNiepmann, Sven Thomas$$b6
000267507 7001_ $$00000-0001-8259-1737$$aBaldus, Stephan$$b7
000267507 7001_ $$00000-0003-0060-1052$$aKelm, Malte$$b8
000267507 7001_ $$aNickenig, Georg$$b9
000267507 7001_ $$0P:(DE-2719)2000062$$aLatz, Eicke$$b10
000267507 7001_ $$00000-0002-1531-2088$$aZimmer, Sebastian$$b11
000267507 773__ $$0PERI:(DE-600)2653953-6$$a10.1161/JAHA.123.031997$$gVol. 13, no. 3, p. e031997$$n3$$pe031997$$tJournal of the American Heart Association$$v13$$x2047-9980$$y2024
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