Comparison of transcatheter aortic valve replacement risk score against currently accepted surgical risk models as predictors of 30‐day mortality in transcatheter aortic valve replacement

Yatsynovich, Yan; Khattak, Himad; Ali, Mohammed; Schwartz, Brian; Pak, Stella; Chen, Tian

doi:10.1111/joic.12442

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Utility of conventional surgical risk scores in predicting outcome after transcatheter aortic valve replacement, presented at American College of Cardiology (ACC) 2013 Scientific Sessions, 9 March 2013, San Francisco, CA, USA). A total of 68,125 patients from these studies were included in the analysis (Figure 1) [4][5][6][7][8][9][10][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . These 24 studies tested 11 different RSMs (7 TAVR-specific, 3 surgical, and 1 designed for use in both TAVR and SAVR patients).…”

Section: Search Resultsmentioning

confidence: 99%

“…If this is the case, additional data (for example, from the continuously growing TVT registry), along with periodic model refinements will probably improve the discrimination. Regular model updates using the most recent outcome data are particularly important in a rapidly evolving field such as TAVR, where device and procedural advances have been shown to reduce periprocedural complications significantly, as reflected by a large heterogeneity of reported outcomes across major studies 22 . A second reason for the weak discrimination could be the inherent inability to discriminate between patients who will or will not die post TAVR.…”

Section: Figure 4 (Cont'd) Forest Plots Displaying the Association Of Each Predictor With Short-term Mortality Baseline Dialysis (A) Was mentioning

confidence: 99%

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Systematic review and meta-analysis of current risk models in predicting short-term mortality after transcatheter aortic valve replacement

Siddiqi¹,

Usman²,

Khan³

et al. 2020

EuroIntervention

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Aims:The aim of this study was to evaluate the performance of risk stratification models (RSMs) in predicting short-term mortality after transcatheter aortic valve replacement (TAVR).Methods and results: MEDLINE and Scopus were queried to identify studies which validated RSMs designed to assess 30-day or in-hospital mortality after TAVR. Discrimination and calibration were assessed using C-statistics and observed/expected ratios (OERs), respectively. C-statistics were pooled using a random-effects inverse-variance method, while OERs were pooled using the Peto odds ratio. A good RSM is defined as one with a C-statistic >0.7 and an OER close to 1.0. Twenty-four studies (n=68,215 patients) testing 11 different RSMs were identified. Discrimination of all RSMs was poor (C-statistic <0.7); however, certain TAVR-specific RSMs such as the in-hospital STS/ACC TVT (C-statistic=0.65) and STT (C-statistic=0.66) predicted individual mortality more reliably than surgical models (C-statistic range=0.59-0.61). A good calibration was demonstrated by the in-hospital STS/ACC TVT (OER=0.99), 30-day STS/ACC TVT (OER=1.08) and STS (OER=1.01) models. Baseline dialysis (OER: 2.64 [1.88, 3.70]; p<0.001) was the strongest predictor of mortality.Conclusions: This study demonstrates that the STS/ACC TVT model (in-hospital and 30-day) and the STS model have accurate calibration, making them useful for comparison of centre-level risk-adjusted mortality. In contrast, the discriminative ability of currently available models is limited.

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Section: Search Resultsmentioning

confidence: 99%

Section: Figure 4 (Cont'd) Forest Plots Displaying the Association Of Each Predictor With Short-term Mortality Baseline Dialysis (A) Was mentioning

confidence: 99%

Systematic review and meta-analysis of current risk models in predicting short-term mortality after transcatheter aortic valve replacement

Siddiqi¹,

Usman²,

Khan³

et al. 2020

EuroIntervention

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“…Consistent with its main aim, this study provides for the first time an original use of currently adopted surgical mortality risk scores to predict the absence of ES after TAVI, as these scores have only been tested so far to predict 1-month and 1-year mortality in this setting, with limited diagnostic accuracy [ 13 ]. Although only the STS-PROM score seemed to foresee 1-month mortality [ 22 ], some authors have already demonstrated its lack of discriminatory power and no difference in prediction accuracy compared to other scores [ 23 , 24 ]. In our cohort, all the risk scores did not demonstrate significant differences between the predicted and observed absence of VARC-2 and VARC-3 ES.…”

Section: Discussionmentioning

confidence: 99%

Surgical Mortality Risk Scores in Transcatheter Aortic Valve Implantation: Is Their Early Predictive Value Still Strong?

Iacovelli

Loizzi

Cafaro

et al. 2023

JCDD

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Background: Surgical mortality risk scores, even if not properly designed and rarely tested in the transcatheter aortic valve implantation (TAVI) setting, still guide the heart team in managing significant aortic stenosis. Methods: After splitting 1763 consecutive patients retrospectively based on their mortality risk thresholds, the composite endpoint early safety (ES) was adjudicated according to Valve Academic Research Consortium (VARC)-2 and -3 consensus documents. Results: ES incidence was higher if VARC-2 rather than VARC-3 defined. Despite only patients showing VARC-2 ES had significantly lower absolute values of all three main risk scores, these last still failed to foresee both VARC-2 and -3 ES in intermediate-risk patients. The receiver operating characteristic analysis also showed a significant correlation, but with poor diagnostic accuracy, among the three scores and only VARC-2 ES; moreover, the absence of VARC-2 ES and low-osmolar contrast media administration were identified as independent predictors of 1-year mortality and absence of VARC-3 ES, respectively. Finally, even a single complication included in the ES definition could significantly affect 1-year mortality. Conclusion: Currently, the most used mortality risk scores do not have adequate diagnostic accuracy in predicting ES after TAVI. The absence of VARC-2, instead of VARC-3, ES is an independent predictor of 1-year mortality.

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Usefulness of Semisupervised Machine-Learning-Based Phenogrouping to Improve Risk Assessment for Patients Undergoing Transcatheter Aortic Valve Implantation

Ghffar

Shrestha

Shaukat

et al. 2020

The American Journal of Cardiology

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Comparison of transcatheter aortic valve replacement risk score against currently accepted surgical risk models as predictors of 30‐day mortality in transcatheter aortic valve replacement

Cited by 5 publications

References 22 publications

Systematic review and meta-analysis of current risk models in predicting short-term mortality after transcatheter aortic valve replacement

Systematic review and meta-analysis of current risk models in predicting short-term mortality after transcatheter aortic valve replacement

Surgical Mortality Risk Scores in Transcatheter Aortic Valve Implantation: Is Their Early Predictive Value Still Strong?

Usefulness of Semisupervised Machine-Learning-Based Phenogrouping to Improve Risk Assessment for Patients Undergoing Transcatheter Aortic Valve Implantation

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