Long-Term Prognostic Value of the Society of Thoracic Surgery Risk Score in Patients Undergoing Transcatheter Aortic Valve Implantation (From the OCEAN-TAVI Registry)

Ishizu, Kenichi; Shirai, Shinichi; Isotani, Akihiro; Hayashi, Masaomi; Kawaguchi, Tomohiro; Taniguchi, Tomohiko; Ando, Kenji; Yashima, Fumiaki; Tada, Norio; Yamawaki, Masahiro; Naganuma, Toru; Yamanaka, Futoshi; Ueno, Hiroshi; Tabata, Minoru; Mizutani, Kazuki; Takagi, Kensuke; Watanabe, Yusuke; Yamamoto, Masanori; Hayashida, Kentaro; Investigators, Ocean-Tavi

doi:10.1016/j.amjcard.2021.03.027

Cited by 24 publications

(17 citation statements)

References 28 publications

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“…However, contrary to our findings, recent Japanese cohort studies have demonstrated that the STS‐PROM score has predictive power for clinical outcomes in older Japanese patients treated with TAVR. 32 , 33 In our study, we noted a higher incidence of primary end point in patients undergoing TAVR with high STS‐PROM score, although this tendency was not statistically significant. If the sample size was larger, the STS‐PROM score might have been significantly associated with the prognosis in patients who underwent TAVR.…”

Section: Discussionmentioning

confidence: 49%

Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis

Suzuki

Toba

Izawa

et al. 2021

JAHA

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Background Myocardial extracellular volume fraction (ECV), measured by cardiac magnetic resonance imaging, is a useful prognostic marker for patients who have undergone aortic valve replacement (AVR) for aortic stenosis. However, the prognostic significance of ECV measurements based on computed tomography (CT) is unclear. This study evaluated the association between ECV measured with dual‐energy CT and clinical outcomes in patients with aortic stenosis who underwent transcatheter or surgical AVR. Methods and Results We retrospectively enrolled 95 consecutive patients (age, 84.0±5.0 years; 75% women) with severe aortic stenosis who underwent preprocedural CT for transcatheter AVR planning. ECV was measured using iodine density images obtained by delayed enhancement dual‐energy CT. The primary end point was a composite outcome of all‐cause death and hospitalization for heart failure after AVR. The mean ECV measured with CT was 28.1±3.8%. During a median follow‐up of 2.6 years, 22 composite outcomes were observed, including 15 all‐cause deaths and 11 hospitalizations for heart failure. In Kaplan‐Meier analysis, the high ECV group (≥27.8% [median value]) had significantly higher rates of composite outcomes than the low ECV group (<27.8%) (log‐rank test, P =0.012). ECV was the only independent predictor of adverse outcomes on multivariable Cox regression analysis (hazards ratio, 1.25; 95% CI, 1.10‒1.41; P <0.001). Conclusions Myocardial ECV measured with dual‐energy CT in patients who underwent aortic valve intervention was an independent predictor of adverse outcomes after AVR.

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Section: Discussionmentioning

confidence: 49%

Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis

Suzuki

Toba

Izawa

et al. 2021

JAHA

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“…A Cox proportional hazards regression analysis was performed to identify predictors of mortality. To test the predictive ability of the nutritional status, multivariable Cox proportional hazard models were constructed, which comprised variables known to be associated with poor prognosis based on clinical plausibility 20 , 21 or P values <0.05 in the univariate analysis. Model 1 was adjusted for preprocedural variables, and model 2 was additionally adjusted for postprocedural variables including echocardiographic data and in‐hospital outcomes.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Prognostic Significance of Malnutrition in Older Japanese Adults at High Surgical Risk Undergoing Transcatheter Aortic Valve Implantation

Ishizu

Shirai

Tashiro

et al. 2022

JAHA

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Background The usefulness of preprocedural nutritional status to stratify prognosis after transcatheter aortic valve implantation has been evaluated; however, the studies conducted so far have been relatively small and/or focused on a single nutritional index. This study sought to assess the prevalence and prognostic impact of malnutrition in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation. Methods and Results We applied the Controlling Nutritional Status score, Geriatric Nutritional Risk Index, and Prognostic Nutritional Index to 1040 consecutive older Japanese patients at high surgical risk who underwent transcatheter aortic valve implantation. According to the Controlling Nutritional Status score, Geriatric Nutritional Risk Index, and Prognostic Nutritional Index, 16.6%, 60.5%, and 13.8% patients had moderate or severe malnutrition, respectively; 89.3% were at least mildly malnourished by at least 1 score. Worse nutritional status was associated with older age, lower body mass index, higher degree of frailty, worse symptoms and renal function, atrial fibrillation, and anemia. During a median follow‐up of 986 days (interquartile range, 556–1402 days), 273 (26.3%) patients died. Compared with normal nutrition, malnutrition was associated with an increased risk for all‐cause death (adjusted hazard ratio for moderate and severe malnutrition, respectively: 2.19 (95% CI, 1.45–3.31; P <0.001) and 6.13 (95% CI, 2.75–13.70; P <0.001) for the Controlling Nutritional Status score, 2.02 (95% CI, 1.36–3.02; P =0.001) and 3.24 (95% CI, 1.86–5.65; P <0.001) for the Geriatric Nutritional Risk Index, and 1.60 (95% CI, 1.06–2.39; P =0.024) and 2.32 (95% CI, 1.50–3.60; P <0.001) for the Prognostic Nutritional Index). Conclusions Malnutrition is common in patients undergoing transcatheter aortic valve implantation and is associated with increased mortality.

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“…2 Again, in the same period, 18% of the patients were categorized as low risk, 46.4% as intermediate risk, and 35.6% as high risk according to STS scores. 3 We do not know the exact risk distribution of the 298 patients who made up the population of the present study. However, from the baseline characteristics of the patients and their baseline STS and EuroSCOREs, we can see that a population of advanced age and considerable comorbidities were analyzed.…”

mentioning

confidence: 90%

“…The database includes two‐thirds of TAVIs conducted in Japan during the period October 2013 to May 2017 when this study was conducted 2 . Again, in the same period, 18% of the patients were categorized as low risk, 46.4% as intermediate risk, and 35.6% as high risk according to STS scores 3 . We do not know the exact risk distribution of the 298 patients who made up the population of the present study.…”

mentioning

confidence: 99%

The implications of the effect of tricuspid regurgitation on mortality in transcatheter aortic valve implantation patients with a low ejection fraction

Korun

2021

Journal of Cardiac Surgery

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Especially in the last decade, after studies showing noninferiority compared to surgical aortic valve replacement in the intermediaterisk group, most research on transcatheter aortic valve implantation (TAVI) has focused on the question of which method is superior in the low-risk group. At this stage, we have come across fewer publications in recent years about the high-risk group in which TAVI has taken its place in the guidelines. In fact, the experience in the world with this group provides an opportunity to analyze the results of the subgroups and to identify possible improvement targets. The article by Imamura et al., 1 published in this issue of the journal, is a good example of such analysis. The authors evaluated the 2-year cardiovascular mortality risk factors of 298 patients with post-TAVI left ventricular (LV) dysfunction from the Optimized CathEter vAlvular iNtervention-Transcatheter Aortic Valve Implantation (OCEAN-TAVI) database, a Japanese database of 2588 patients. One of the key findings is that moderate or severe tricuspid regurgitation increases 2-year mortality approximately threefold. Another important finding is that improvement in tricuspid regurgitation in the first year after the procedure tends to reduce the risk of 2-year mortality. The OCEAN-TAVI database is a prospectively generated multicenter database from Japan. A quick search of Pubmed lists more than 60 articles written using this database. The database includes two-thirds of TAVIs conducted in Japan during the period October 2013 to May 2017 when this study was conducted. 2 Again, in the

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Long-Term Prognostic Value of the Society of Thoracic Surgery Risk Score in Patients Undergoing Transcatheter Aortic Valve Implantation (From the OCEAN-TAVI Registry)

Cited by 24 publications

References 28 publications

Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis

Prognostic Impact of Myocardial Extracellular Volume Fraction Assessment Using Dual‐Energy Computed Tomography in Patients Treated With Aortic Valve Replacement for Severe Aortic Stenosis

Prevalence and Prognostic Significance of Malnutrition in Older Japanese Adults at High Surgical Risk Undergoing Transcatheter Aortic Valve Implantation

The implications of the effect of tricuspid regurgitation on mortality in transcatheter aortic valve implantation patients with a low ejection fraction

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