Objective  To investigate the impact of baseline neutrophil-to-lymphocyte ratio (NLR) on all-cause mortality after transcatheter aortic valve replacement (TAVR) in patients with aortic regurgitation (AR).

Methods Patients with AR who underwent TAVR at Xijing Hospital of Air Force Medical University from October 2018 to June 2024 were consecutively enrolled. According to the receiver operating characteristic (ROC) curve analysis, patients were divided into low-NLR groups (NLR ＜ 2.86) and a high-NLR group (NLR≥2.86). Survival analysis was performed using the Kaplan-Meier method and compared between groups with the log-rank test. A Cox proportional hazards model was used to determine the association of NLR with post-TAVR clinical events and all-cause mortality in patients with AR.

Results A total of 187 patients with AR were included. The low-NLR group comprised 108 patients, including 60 males and 48 females, with a mean age of (68.53±7.64) years. The high-NLR group comprised 79 patients, including 54 males and 25 females, with a mean age of (67.80±8.28) years. At a median follow-up of 18 months (maximum follow-up: 64 months), the cumulative incidence of all-cause mortality was higher in the high-NLR group than in low-NLR group (18.7% vs. 2.8%, P = 0.012). Multivariate Cox regression analysis showed that high NLR was an independent risk factor for all-cause mortality after TAVR (HR = 4.75, 95%CI: 1.29-17.47, P = 0.019).

Conclusion A higher baseline NLR is an independent risk factor for mid- to long-term all-cause mortality after TAVR in patients with AR.