HIGS-score voorspelt pacemaker-implantatie en sterfte na TAVI

BACKGROUND: Permanent pacemaker implantation (PPI) and early mortality remain important complications after transcatheter aortic valve implantation (TAVI). The Hematological Inflammatory Global Score (HIGS), derived from routine hematological parameters, may provide prognostic information after TAVI. This study evaluated the association of HIGS with PPI and in-hospital mortality. METHODS: This retrospective single-center study included 196 consecutive patients undergoing TAVI (mean age 78.2 ± 6.9 years; 71.4% male). HIGS was calculated using standardized values of red cell distribution width, platelet distribution width, and immature granulocyte percentage. Associations with outcomes were assessed using logistic regression, and discrimination was evaluated by receiver operating characteristic analysis. RESULTS: PPI occurred in 43 patients (21.9%) and in-hospital mortality in 34 (17.3%). HIGS was higher in patients with PPI and in those who died (both p < 0.001). In multivariable analysis, HIGS remained independently associated with PPI (OR 3.96, 95% CI 1.79-8.76, p < 0.001) and mortality (OR 4.92, 95% CI 2.12-11.41, p < 0.001). HIGS showed good discrimination for PPI (AUC 0.84) and mortality (AUC 0.87), and improved conventional clinical models. CONCLUSIONS: Higher HIGS values were independently associated with PPI and in-hospital mortality after TAVI. HIGS may be a simple, readily available risk-stratification marker, although prospective multicenter validation is required.