Comparison of three contemporary surgical scores for predicting all-cause mortality of patients undergoing percutaneous mitral valve repair with the MitraClip system (from the multicenter GRASP-IT registry)

Marianna Adamo, Davide Capodanno, Stefano Cannata, Cristina Giannini, Maria Luisa Laudisa, Marco Barbanti, Salvatore Curello, Sebastiano Immè, Diego Maffeo, Carmelo Grasso, Francesco Bedogni, Anna Sonia Petronio, Federica Ettori, Corrado Tamburino

Research output: Contribution to journalArticle

Abstract

The aim of this study was to explore the adaptability of 3 contemporary surgical scores (Logistic EuroSCORE [LES], EuroSCORE II [ESII], and Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM]) for prediction of mortality after percutaneous mitral valve repair with the MitraClip system. A total of 304 patients from the multicenter Getting Reduction of mitrAl inSufficiency by Percutaneous clip implantation in ITaly registry (GRASP-IT) were stratified based on LES, ESII, and STS-PROM tertiles and analyzed by different measurements of discrimination, calibration, and global accuracy with focus on 30-day and 1-, 2-, and 3-year mortality. A statistically significant gradient in the distribution of mortality was observed at all time points with ESII, at 2 years with LES, and at 2 and 3 years with STS-PROM. ESII had the best discrimination at 30 days (C-statistic 0.80), which remained acceptable at later follow-up, being significantly superior to that of LES at each time point (p = 0.003 at 30 days, p = 0.005 at 1 year, p = 0.011 at 2 years, and p = 0.029 at 3 years). Compared with STS-PROM, ESII showed better discrimination at 30 days (C-statistic 0.80 vs 0.62, p = 0.023). All scores overpredicted the risk of mortality at 30 days and were miscalibrated at 2 and 3 years. At 1 year, there was a good agreement between the observed and predicted probabilities for ESII and STS-PROM, whereas LES remained overpredictive. ESII showed the best global accuracy at 30 days and 1 year, whereas no notable differences were noted versus LES and STS-PROM at 2 and 3 years. In conclusion, lacking specific tools for risk stratification of patients undergoing MitraClip implantation, ESII holds favorable prognostic characteristics, which makes it a valid surrogate.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalThe American Journal of Cardiology
Volume115
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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    Adamo, M., Capodanno, D., Cannata, S., Giannini, C., Laudisa, M. L., Barbanti, M., Curello, S., Immè, S., Maffeo, D., Grasso, C., Bedogni, F., Petronio, A. S., Ettori, F., & Tamburino, C. (2015). Comparison of three contemporary surgical scores for predicting all-cause mortality of patients undergoing percutaneous mitral valve repair with the MitraClip system (from the multicenter GRASP-IT registry). The American Journal of Cardiology, 115(1), 107-112. https://doi.org/10.1016/j.amjcard.2014.09.051