Usefulness and validation of the survival post TAVI score for survival after transcatheter aortic valve implantation for aortic stenosis

Fabrizio D'Ascenzo, Davide Capodanno, Giuseppe Tarantini, Freek Nijhoff, Cristina Ciuca, Marco Luciano Rossi, Nedy Brambilla, Marco Barbanti, Massimo Napodano, Pieter Stella, Francesco Saia, Giuseppe Ferrante, Corrado Tamburino, Valeria Gasparetto, Pierfrancesco Agostoni, Antonio Marzocchi, Patrizia Presbitero, Francesco Bedogni, Enrico Cerrato, Pierluigi OmedèFederico Conrotto, Stefano Salizzoni, Giuseppe Biondi Zoccai, Sebastiano Marra, Mauro Rinaldi, Fiorenzo Gaita, Maurizio D'Amico, Claudio Moretti

Research output: Contribution to journalArticlepeer-review

Abstract

Surgical risk scores fail to accurately predict mortality after transcatheter aortic valve implantation (TAVI). The aimof this study was to develop and validate a dedicated risk score for accurate estimation of mortality risk in these patients. All consecutive patients who underwent TAVI at 6 international institutionswere enrolled. Predictors for 1-year all-causemortality were identified by means of Cox multivariate analysis and incorporated in a prediction score. Accuracy of the score was derived and externally validated for 30-day and 1-year mortality. The net classification improvement comparedwith the Society ofThoracic Surgeons (STS) scorewas appraised. A total of 1,064 patients constituted the derivation cohort and 180 patients constituted the external validation cohort. A total of 165 patients (15%) died at 1-year follow-up. Previous stroke (odds ratio [OR] 1.80, 1.4 to 3), inverse of renal clearance (OR 8, 6 to 14), and systolic pulmonary arterial pressure ≥50mmHg (OR 2.10, 1.5 to 3) were independently related to 1-year mortality. Area under the curve (AUC) of the survival post TAVI (STT) for 1-year mortality was 0.68 (0.62 to 0.71). At 30 days, 65 patients (7%) had died and the AUC for the STT at this time point was 0.66 (0.64 to 0.75). In the external validation cohorts, theAUC of the STT were 0.66 (0.56 to 0.7) for 30-day and 0.67 (0.62 to 0.71) for 1-year mortality. Net reclassification improvement for STT compared with STS was 31% (p

Original languageEnglish
Pages (from-to)1867-1874
Number of pages8
JournalThe American Journal of Cardiology
Volume114
Issue number12
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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