Geriatric nutritional risk index and C-reactive protein: prognostic impact in transcatheter aortic valve implantation

The impact of inflammatory and nutritional indices in patients undergoing transcatheter aortic valve implantation (TAVI) remains controversial. Therefore, we aimed to analyze the prognostic impact of Geriatric Nutritional Risk Index (GNRI) and C-reactive protein (CRP) in these patients. We included 122 patients who underwent elective TAVI for aortic valve stenosis (AS) between April 2017 and May 2023. The primary outcome was all-cause mortality, and secondary outcomes were major adverse cerebral/cardiovascular events (MACCEs). Patients with a low GNRI, high CRP levels, and a combination of a low GNRI and high CRP levels exhibited significantly high all-cause mortality. The GNRI and CRP levels alone were significantly associated with late mortality in the univariate analysis; however, this trend was absent in the multivariate analysis. The combination of a low GNRI and high CRP levels was significantly associated with late mortality in the univariate and multivariate analyses. The GNRIs at 6 months showed no significant changes, and the low GNRI in patients before surgery persisted after TAVI. There was no association between low GNRI after TAVI and late mortality or MACCE. The combination of malnutrition (indicated by a low GNRI) and inflammation (indicated by high CRP levels) may be a risk factor for long-term mortality in patients undergoing TAVI for AS.