Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement

Hioki, Hirofumi; Watanabe, Yusuke; Kozuma, Ken; Yamamoto, Masanori; Naganuma, Toru; Araki, Motoharu; Tada, Norio; Shirai, Shinichi; Yamanaka, Futoshi; Higashimori, Akira; Mizutani, Kazuki; Tabata, Minoru; Takagi, Kensuke; Ueno, Hiroshi; Hayashida, Kentaro; Investigators, Ocean-Tavi

doi:10.1002/ccd.27547

Cited by 12 publications

(10 citation statements)

References 33 publications

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“…Furthermore, low BMI (<20 kg/m 2 ) was one of the factors related to frailty according to the VARC‐2 criteria 13 . We reported the poor prognosis of low, lean BMI using a previous formula 15 . Although the additional predictive value of lean BMI on BMI could be probably be derived, the complex calculation might be impractical in daily practice.…”

Section: Discussionmentioning

confidence: 97%

“…Comparisons of the baseline characteristics between the two cohorts were made using χ 2 tests for categorical variables and unpaired Student's t ‐test for continuous variables listed as mean values and Mann–Whitney U test for continuous variables listed as median values. We used the following variables as candidate predictors for incorporation into the risk prediction in conjunction with our previous reports 10‐12,14‐17 : sex, body mass index (BMI), Clinical Frailty Scale (CFS), New York Heart Association (NYHA) class, history of prior cardiac surgery, serum albumin concentration, estimated glomerular filtration rate (eGFR), presence of pulmonary disease, STS score, atrial fibrillation (AF), peripheral artery disease (PAD), liver disease, and active cancer. In addition, echocardiographic parameters such as left ventricle ejection fraction (LVEF) and stroke volume index were also considered.…”

Section: Methodsmentioning

confidence: 99%

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Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

Yamamoto

Otsuka

Shimura

et al. 2020

Cathet Cardio Intervent

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Objectives Estimating 1‐year life expectancy is an essential factor when evaluating appropriate indicators for transcatheter aortic valve replacement (TAVR). Background It is clinically useful in developing a reliable risk model for predicting 1‐year mortality after TAVR. Methods We evaluated 2,588 patients who underwent TAVR using data from the Optimized CathEter vAlvular iNtervention (OCEAN) Japanese multicenter registry from October 2013 to May 2017. The 1‐year clinical follow‐up was achieved by 99.5% of the entire population (n = 2,575). Patients were randomly divided into two cohorts: the derivation cohort (n = 1,931, 75% of the study population) and the validation cohort (n = 644). Considerable clinical variables including individual patient's comorbidities and frailty markers were used for predicting 1‐year mortality following TAVR. Results In the derivation cohort, a multivariate logistic regression analysis demonstrated that sex, body mass index, Clinical Frailty Scale, atrial fibrillation, peripheral artery disease, prior cardiac surgery, serum albumin, renal function as estimated glomerular filtration rate, and presence of pulmonary disease were independent predictors of 1‐year mortality after TAVR. Using these variables, a risk prediction model was constructed to estimate the 1‐year risk of mortality after TAVR. In the validation cohort, the risk prediction model revealed high discrimination ability and acceptable calibration with area under the curve of 0.763 (95% confidence interval, 0.728–0.795, p < .001) in the receiver operating characteristics curve analysis and a Hosmer–Lemeshow χ2 statistic of 5.96 (p = .65). Conclusions This risk prediction model for 1‐year mortality may be a reliable tool for risk stratification and identification of adequate candidates in patients undergoing TAVR.

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Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

Yamamoto

Otsuka

Shimura

et al. 2020

Cathet Cardio Intervent

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“…Seven studies [28,34,37,39,[42][43][44] (9251 patients) were included in the analysis for patients who were underweight (BMI <20 kg/m 2 ) at baseline. The pooled result of the random effects model was an HR of 1.49 (95% CI: 1.10-2.03).…”

Section: Underweight (Bmi <20)mentioning

confidence: 99%

Preoperative frailty parameters as predictors for outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis

et al. 2020

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Guidelines suggest using frailty characteristics in the work-up for a transcatheter aortic valve implantation (TAVI). There are many frailty-screening tools with different components. The prognostic value of the individual parameters in frailty is as yet unclear. The objective of this systematic review and meta-analysis was to find and pool predictors for 1-year mortality after TAVI. We followed a twostep approach. First, we searched for randomised controlled trials on TAVI to identify frailty parameters used in these studies. Second, we searched for publications on these frailty parameters. Articles were included for pooled analysis if the studied frailty parameters were dichotomised with clear cutoff values based on common standards or clinical practice and reported adjusted hazard ratios (HR) of 1-year mortality after TAVI. We calculated pooled effect estimates of 49 studies based on dichotomised frailty scores (

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“…11,12 Low lean body mass, which represents sarcopenia, was also associated with higher mortality. 13 Interestingly, cognitive impairment was also associated with increased incidence of sepsis, resulting in higher 1-year mortality in this registry. 14 Last but not least, the CFS, which is a simple eye-ballevaluated scale, was predictive of death after TAVI.…”

Section: Editorialmentioning

confidence: 72%

Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement

Cited by 12 publications

References 33 publications

Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

Preoperative frailty parameters as predictors for outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis

Frailty Assessment　― An Indispensable Component of Transcatheter Aortic Valve Implantation ―

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Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement

Cited by 12 publications

References 33 publications

Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

Clinical risk model for predicting 1‐year mortality after transcatheter aortic valve replacement

Preoperative frailty parameters as predictors for outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis

Frailty Assessment ― An Indispensable Component of Transcatheter Aortic Valve Implantation ―

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Frailty Assessment　― An Indispensable Component of Transcatheter Aortic Valve Implantation ―