<h2 class="section-title u-h3 u-margin-l-top u-margin-xs-bottom">Abstract</h2> <div id="as0005"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0010">Background</h3> <p id="sp0100"><span>Little is known about changes in nutritional status as an index of frailty on clinical outcomes after<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/percutaneous-aortic-valve-replacement" title="Learn more about transcatheter aortic valve replacement from ScienceDirect's AI-generated Topic Pages">transcatheter aortic valve replacement</a><span> </span>(TAVR). This study aimed to assess the clinical impact of<span> </span></span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/serum-albumin" title="Learn more about serum albumin from ScienceDirect's AI-generated Topic Pages">serum albumin</a><span> </span>changes after TAVR.</p> </div> <div id="as0010"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0015">Methods</h3> <p id="sp0105"><span>Changes in serum<span> </span><a href="https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/albumin-level" title="Learn more about albumin levels from ScienceDirect's AI-generated Topic Pages">albumin levels</a><span> </span>from baseline to 1 year after TAVR were evaluated in 1524 patients who were classified as having<span> </span></span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hypoalbuminemia" title="Learn more about hypoalbuminemia from ScienceDirect's AI-generated Topic Pages">hypoalbuminemia</a><span><span> </span>(<3.5 g/dl) and normoalbuminemia (≥3.5 g/dl) at each timepoint. The patients were categorized into 4 groups: NN (baseline normoalbuminemia, 1-year normoalbuminemia: n = 1119), HN (baseline<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hypoalbuminemia" title="Learn more about hypoalbuminemia from ScienceDirect's AI-generated Topic Pages">hypoalbuminemia</a>, 1-year normoalbuminemia: n = 202), NH (baseline normoalbuminemia, 1-year hypoalbuminemia: n = 121), and HH (baseline hypoalbuminemia, 1-year hypoalbuminemia: n = 82). We also defined late hypoalbuminemia as hypoalbuminemia identified at the 1-year assessment. Clinical outcomes were compared among 4 groups. Multivariable analysis was driven to assess the variables associated with late hypoalbuminemia and long-term mortality.</span></p> </div> <div id="as0015"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0020">Results</h3> <p id="sp0110">The cumulative 3-year mortality was significantly different among the 4 groups (NN: 11.4%, HN: 10.7%, NH: 25.4%, HH: 44.4%, p < 0.001). Multivariable<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/proportional-hazards-model" title="Learn more about Cox regression from ScienceDirect's AI-generated Topic Pages">Cox regression</a><span><span> </span>analysis revealed that the NH group had a higher mortality risk (hazard ratio [HR]; 2.80 and 3.53, 95% confidence interval [CI]; 1.71–4.57 and 2.06–6.06, p < 0.001 and p < 0.001, respectively), whereas the HN group had a similar risk (HR; 1.16, 95% CI; 0.66–2.06, p = 0.61) compared with the NN group. Baseline hypoalbuminemia, low body mass index, liver disease,<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/arteriosclerosis-obliterans" title="Learn more about peripheral artery disease from ScienceDirect's AI-generated Topic Pages">peripheral artery disease</a>, and hospital readmission within 1 year were predictors of late hypoalbuminemia (all p < 0.05).</span></p> </div> <div id="as0020"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0025">Conclusion</h3> <p id="sp0115">Serial albumin assessment may identify poor prognostic subsets in patients with persistent and late acquired malnutrition after TAVR.</p> </div>