{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:10:34Z","timestamp":1788786634778,"version":"build-2803163510"},"reference-count":31,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004166","name":"Medical University of Warsaw","doi-asserted-by":"publisher","award":["1WR\/NM1\/16"],"award-info":[{"award-number":["1WR\/NM1\/16"]}],"id":[{"id":"10.13039\/501100004166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004166","name":"Medical University of Warsaw","doi-asserted-by":"publisher","award":["1WR\/NM3\/16"],"award-info":[{"award-number":["1WR\/NM3\/16"]}],"id":[{"id":"10.13039\/501100004166","id-type":"DOI","asserted-by":"publisher"}]},{"award":["1WR\/NM1\/16"],"award-info":[{"award-number":["1WR\/NM1\/16"]}],"id":[{"id":"https:\/\/ror.org\/04p2y4s44","id-type":"ROR","asserted-by":"publisher"}]},{"award":["1WR\/NM3\/16"],"award-info":[{"award-number":["1WR\/NM3\/16"]}],"id":[{"id":"https:\/\/ror.org\/04p2y4s44","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Vascular and bleeding complications drive procedural mortality in transvenous lead extraction (TLE), yet contemporary risk scores include no pre-procedural laboratory measure of haemostasis or inflammation. We evaluated whether a routine inflammation\u2013haemostasis panel (coagulation tests, blood counts and C-reactive protein [CRP]) and peri-procedural matrix metalloproteinase-9 (MMP-9) dynamics predict technical intra-procedural complexity. Methods: Fifty-four procedures in 53 consecutive patients at a single tertiary centre were analysed prospectively (50% infective; 86 leads). Technical complexity (prolonged procedure or fluoroscopy time; advanced-tool use) was modelled with the number of extracted leads as a predictor rather than an outcome component, in prespecified and stepwise-selected logistic models with bootstrap optimism correction. Results: The infective indication predicted extraction extent (\u22652 leads: 70% vs. 22%) but not technical complexity: the time-based endpoint was not associated with the indication (OR 0.38, p = 0.16), and only cumulative lead dwell time predicted advanced-tool use (OR 1.27 per year; optimism-corrected area under the curve [AUC] 0.72). No routine panel variable predicted any technical endpoint, and none survived multiplicity correction. MMP-9 neither changed peri-procedurally nor differed between indications. A principal-component composite did not improve on CRP alone (AUC 0.66 vs. 0.69; p = 0.67), and the full panel\u2019s apparent AUC (0.84) fell to 0.71 after optimism correction. Conclusions: No routine pre-procedural inflammation\u2013haemostasis variable predicted technical complexity; the infective indication\u2019s apparent association reflected guideline-mandated complete system removal\u2014extraction extent\u2014rather than technical difficulty. These exploratory findings support dwell-time- and anatomy-anchored risk scoring, directed haemostasis-activation markers rather than routine screening, and prospective studies capturing bleeding endpoints.<\/jats:p>","DOI":"10.3390\/jcm15176923","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:12:25Z","timestamp":1788783145000},"page":"6923","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Routine Inflammation\u2013Haemostasis Panel in Transvenous Lead Extraction: An Exploratory Prospective Single-Centre Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3820-4378","authenticated-orcid":false,"given":"Jakub K.","family":"Rokicki","sequence":"first","affiliation":[{"name":"Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00-587 Warsaw, Poland"},{"name":"First Department of Cardiology, Medical University of Warsaw, 00-587 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4826-5545","authenticated-orcid":false,"given":"Sylwia","family":"Wolff","sequence":"additional","affiliation":[{"name":"National Oncology Institute of Maria Sklodowska-Curie\u2014National Research Institute in Warsaw, 01-045 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6286-4651","authenticated-orcid":false,"given":"\u0141ukasz","family":"Januszkiewicz","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Medical University of Warsaw, 00-587 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4220-0855","authenticated-orcid":false,"given":"Marcin","family":"Michalak","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Medical University of Warsaw, 00-587 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-9409","authenticated-orcid":false,"given":"Katarzyna","family":"Czarzasta","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, 00-587 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Cacko","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00-587 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Opolski","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Medical University of Warsaw, 00-587 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3306-0301","authenticated-orcid":false,"given":"Marcin","family":"Grabowski","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Medical University of Warsaw, 00-587 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2995","DOI":"10.1093\/eurheartj\/ehx080","article-title":"The European Lead Extraction ConTRolled (ELECTRa) study: A European Heart Rhythm Association (EHRA) Registry of Transvenous Lead Extraction Outcomes","volume":"38","author":"Bongiorni","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1093\/europace\/euy300","article-title":"Major cardiac and vascular complications after transvenous lead extraction: Acute outcome and predictive factors from the ESC-EHRA ELECTRa (European Lead Extraction ConTRolled) registry","volume":"21","author":"Zucchelli","year":"2019","journal-title":"Europace"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1093\/europace\/euz246","article-title":"European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections-endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"22","author":"Traykov","year":"2020","journal-title":"Europace"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Jache\u0107, W., Polewczyk, A., Polewczyk, M., Tomasik, A., and Kutarski, A. (2020). Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020361"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"668","DOI":"10.2459\/JCM.0000000000000023","article-title":"Predicting the difficulty of a lead extraction procedure: The LED index","volume":"15","author":"Bontempi","year":"2014","journal-title":"J. Cardiovasc. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/jce.13223","article-title":"Predicting the difficulty of a transvenous lead extraction procedure: Validation of the LED index","volume":"28","author":"Bontempi","year":"2017","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1093\/europace\/euab037","article-title":"Risk stratification of patients undergoing transvenous lead extraction with the ELECTRa Registry Outcome Score (EROS): An ESC EHRA EORP European lead extraction ConTRolled ELECTRa registry analysis","volume":"23","author":"Sidhu","year":"2021","journal-title":"Europace"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3098","DOI":"10.1016\/j.jacc.2018.09.068","article-title":"Prevention of Arrhythmia Device Infection Trial: The PADIT Trial","volume":"72","author":"Krahn","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/s10840-024-01759-1","article-title":"Device infection in patients undergoing pacemaker or defibrillator surgery: Risk stratification using the PADIT score","volume":"67","author":"Holl","year":"2024","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Jache\u0107, W., Nowosielecka, D., Ziaja, B., Polewczyk, A., and Kutarski, A. (2023). LECOM (Lead Extraction COMplexity): A New Scoring System for Predicting a Difficult Procedure. J. Clin. Med., 12.","DOI":"10.3390\/jcm12247568"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.hrthm.2021.12.036","article-title":"Machine learning-derived major adverse event prediction of patients undergoing transvenous lead extraction: Using the ESC EHRA EORP European lead extraction ConTRolled ELECTRa registry","volume":"19","author":"Mehta","year":"2022","journal-title":"Heart Rhythm"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1111\/pace.15034","article-title":"Computed tomography predictors of increased transvenous lead extraction difficulty","volume":"47","author":"Patel","year":"2024","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"euaf308","DOI":"10.1093\/europace\/euaf308","article-title":"Pre-procedural computed tomography predicts procedural complexity and complications in bidirectional rotational mechanical transvenous lead extraction","volume":"27","author":"Migliore","year":"2025","journal-title":"Europace"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1093\/europace\/euz062","article-title":"Clinical impact of antithrombotic therapy in transvenous lead extraction complications: A sub-analysis from the ESC-EORP EHRA ELECTRa (European Lead Extraction ConTRolled) Registry","volume":"21","author":"Auricchio","year":"2019","journal-title":"Europace"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1093\/europace\/euy050","article-title":"2018 EHRA expert consensus statement on lead extraction: Recommendations on definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries: Endorsed by APHRS\/HRS\/LAHRS","volume":"20","author":"Bongiorni","year":"2018","journal-title":"Europace"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.hrthm.2010.05.016","article-title":"Cardiac implantable electronic device infections: Presentation, management, and patient outcomes","volume":"7","author":"Tarakji","year":"2010","journal-title":"Heart Rhythm"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lennerz, C., Vrazic, H., Haller, B., Braun, S., Petzold, T., Ott, I., Lennerz, A., Michel, J., Bla\u017eek, P., and Deisenhofer, I. (2017). Biomarker-based diagnosis of pacemaker and implantable cardioverter defibrillator pocket infections: A prospective, multicentre, case-control evaluation. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172384"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.hroo.2024.04.007","article-title":"Inflammatory biomarkers as predictors of systemic vs. isolated pocket infection in patients undergoing transvenous lead extraction","volume":"5","author":"Toomu","year":"2024","journal-title":"Heart Rhythm O2"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.33963\/v.phj.109025","article-title":"An increase in cardiac troponin T levels after transvenous lead extraction","volume":"83","author":"Kosior","year":"2025","journal-title":"Kardiol. Pol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"64","DOI":"10.33963\/KP.a2021.0141","article-title":"The impact of complications related to transvenous lead extraction on the 12-month prognosis: Insights from the SILCARD registry","volume":"80","author":"Tajstra","year":"2022","journal-title":"Pol. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.ehj.2003.10.022","article-title":"Long-term survival after pacemaker implantation. Prognostic importance of gender and baseline patient characteristics","volume":"25","author":"Brunner","year":"2004","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Kutarski, A., Jache\u0107, W., Polewczyk, A., and Nowosielecka, D. (2023). Incomplete Lead Removal During the Extraction Procedure: Predisposing Factors and Impact on Long-Term Survival in Infectious and Non-Infectious Cases: Analysis of 3741 Procedures. J. Clin. Med., 12.","DOI":"10.3390\/jcm12082837"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Barca, L., Mascia, G., Di Donna, P., Sartori, P., Bianco, D., Della Bona, R., Benenati, S., Merlo, A.C., Buongiorno, A.L., and Kaufman, N. (2023). Long-Term Outcomes of Transvenous Lead Extraction: A Comparison in Patients with or without Infection from the Italian Region with the Oldest Population. J. Clin. Med., 12.","DOI":"10.3390\/jcm12134543"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"341740","DOI":"10.1155\/2015\/341740","article-title":"Matrix Metalloproteinase-9 Production following Cardiopulmonary Bypass Was Not Associated with Pulmonary Dysfunction after Cardiac Surgery","volume":"2015","author":"Lin","year":"2015","journal-title":"Mediat. Inflamm."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1016\/j.jacc.2007.02.040","article-title":"Plasma concentrations of myeloperoxidase predict mortality after myocardial infarction","volume":"49","author":"Mocatta","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e20190103","DOI":"10.1084\/jem.20190103","article-title":"Transforming growth factor-\u03b2 in tissue fibrosis","volume":"217","author":"Frangogiannis","year":"2020","journal-title":"J. Exp. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Keiler, J., Schulze, M., Dreger, R., Springer, A., Oner, A., and Wree, A. (2020). Quantitative and Qualitative Assessment of Adhesive Thrombo-Fibrotic Lead Encapsulations (TFLE) of Pacemaker and ICD Leads in Arrhythmia Patients\u2014A Post Mortem Study. Front. Cardiovasc. Med., 7.","DOI":"10.3389\/fcvm.2020.602179"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1111\/j.1742-1241.2010.02338.x","article-title":"Extraction of cardiac rhythm devices: Indications, techniques and outcomes for the removal of pacemaker and defibrillator leads","volume":"64","author":"Farooqi","year":"2010","journal-title":"Int. J. Clin. Pract."},{"key":"ref_29","first-page":"1226","article-title":"D-Dimer formation during cardiac and noncardiac thoracic surgery","volume":"88","author":"Whitten","year":"1999","journal-title":"Anesth. Analg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S1053-0770(05)80008-4","article-title":"Significance of D-dimer concentrations during and after cardiopulmonary bypass","volume":"10","author":"Comunale","year":"1996","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/jce.16147","article-title":"Safety and feasibility of same-day discharge following uncomplicated transvenous lead extraction","volume":"35","author":"Gianni","year":"2024","journal-title":"J. Cardiovasc. Electrophysiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6923\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:42:57Z","timestamp":1788784977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":31,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176923"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176923","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]}}}