Evidence mapPaperPMID 42520093Full record

ArticlePloS one2026

De Ritis (AST/ALT) ratio as a predictor of early adverse outcomes following transcatheter aortic valve replacement.

Haitham Abu Khadija, Jebrin Alkrinawi, Ali Abdullah, Omar Ayyad, Ammar Barakat, Salma Najjar, Alexander Kogan, Leonid Sternik, Alaa Shehady, Mohammad Masu'd and 2 more

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Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Haitham Abu KhadijaHeart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel.ORCID https://orcid.org/0000-0002-2336-3125
Jebrin AlkrinawiHeart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel.
Ali AbdullahInstitute of Gastroenterology and Liver Disease, Kaplan Medical Center, Rehovot, Israel, affiliated with the Hebrew University, Jerusalem, Israel.
Omar AyyadHeart Center, Kaplan Medical Center, Rehovot, affiliated with the Hebrew University, Jerusalem, Israel.
Ammar BarakatDepartment of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Salma NajjarDepartment of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.ORCID https://orcid.org/0009-0000-9716-2951
Alexander KoganDepartment of Cardiac Surgery, The Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, Israel.
Leonid SternikDepartment of Cardiac Surgery, The Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, Israel.
Alaa ShehadyDepartment of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.ORCID https://orcid.org/0009-0003-6427-0683
Mohammad Masu'dDepartment of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Duha NajajraDepartment of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Mohammad AlneesDepartment of Internal Medicine B, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.ORCID https://orcid.org/0000-0002-5577-8499

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSimple biochemical markers that capture systemic stress could refine short-term risk stratification after TAVR. We evaluated whether an elevated AST/ALT ratio predicts early adverse outcomes following transfemoral TAVR.

methodsWe retrospectively analyzed 733 consecutive patients undergoing transfemoral TAVR. The exposure was the preprocedural AST/ALT ratio categorized as low (<1.4; n = 478) or high (≥1.4; n = 255). Baseline characteristics were compared using t/Wilcoxon tests and χ²/Fisher's exact tests. Thirty-day endpoints included all-cause mortality, acute kidney injury (AKI), stroke, and new-onset atrial fibrillation (NOAF). Kaplan-Meier failure curves were compared by the log-rank test. Cox models estimated hazard ratios (HRs) with 95% CIs; candidate covariates were prespecified and further refined with LASSO (10-fold cross-validation). Model assumptions were checked with Schoenfeld residuals.

resultsHigh AST/ALT was associated with greater 30-day risk of AKI (adjusted HR 3.18, 95% CI 1.80-5.63), stroke (adjusted HR 2.73, 95% CI 1.31-5.69), and NOAF (adjusted HR 2.35, 95% CI 1.57-3.51). For mortality, the crude association was not statistically significant (HR 2.07, 95% CI 0.91-4.68; p = 0.082) and remained non-significant after adjustment (HR 1.74, 95% CI 0.75-4.04; p = 0.197). Additional adjusted associations included higher AKI risk with high-intensity statins (HR 3.51, 95% CI 1.75-7.06) and baseline complete right bundle-branch block (HR 3.77, 95% CI 1.49-9.57).

conclusionsAn elevated preprocedural AST/ALT ratio independently identifies TAVR recipients at increased 30-day risk of AKI, stroke, and NOAF, but not mortality. Incorporating this inexpensive marker into routine assessment may help tailor periprocedural strategies and early surveillance after TAVR.

Indexed as

Alanine TransaminaseAortic Valve StenosisAspartate AminotransferasesPostoperative ComplicationsTranscatheter Aortic Valve ReplacementAcute Kidney InjuryAgedAged, 80 and overAtrial FibrillationBiomarkersFemaleHumansKaplan-Meier EstimateMaleProportional Hazards ModelsRetrospective StudiesAlanine TransaminaseAspartate AminotransferasesBiomarkers

Identifiers

PMID42520093
PMCPMC13411933

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.