Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis Undergoing Transcatheter Valve Replacement

Background: In-depth knowledge about potential predictors of mortality in transcatheter aortic valve replacement (TAVR) is still warranted. Currently used risk stratification models for TAVR often fail to reach a holistic approach. We, therefore, aimed to create a new staged risk model for 1-year mortality including several new categories including (a) AS-entities (b) cardiopulmonary hemodynamics (c) comorbidities, and (d) different access routes. Methods: 737 transfemoral (TF) TAVR (84.3%) and 137 transapical (TA) TAVR (15.7%) patients were included. Predictors of 1-year mortality were assessed according to the aforementioned categories. Results: Over-all 1-year mortality (n = 100, 11.4%) was significantly higher in the TA TAVR group (TF vs. TA TAVR: 10.0% vs. 18.9 %; p = 0.0050*). By multivariate cox-regression analysis, a three-staged model was created in patients with fulfilled categories (TF TAVR: n = 655, 88,9%; TA TAVR: n = 117, 85.4%). Patients in “stage 2” showed 1.7-fold (HR 1.67; CI 1.07–2.60; p = 0.024*) and patients in “stage 3” 3.5-fold (HR 3.45; CI 1.97–6.05; p < 0.0001*) enhanced risk to die within 1 year. Mortality increased with every stage and reached the highest rates of 42.5% in “stage 3” (p_logrank < 0.0001*), even when old- and new-generation devices (p_logrank = n.s) were sub-specified. Conclusions: This new staged mortality risk model had incremental value for prediction of 1-year mortality after TAVR independently from the TAVR-era. View Full-Text

Keywords: outcome; risk scores; TAVR

▼ Show Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Share and Cite

MDPI and ACS Style

Veulemans, V.; Polzin, A.; Maier, O.; Klein, K.; Wolff, G.; Hellhammer, K.; Afzal, S.; Piayda, K.; Jung, C.; Westenfeld, R.; Blehm, A.; Lichtenberg, A.; Kelm, M.; Zeus, T. Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis Undergoing Transcatheter Valve Replacement. J. Clin. Med. 2019, 8, 1642. https://doi.org/10.3390/jcm8101642

AMA Style

Veulemans V, Polzin A, Maier O, Klein K, Wolff G, Hellhammer K, Afzal S, Piayda K, Jung C, Westenfeld R, Blehm A, Lichtenberg A, Kelm M, Zeus T. Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis Undergoing Transcatheter Valve Replacement. Journal of Clinical Medicine. 2019; 8(10):1642. https://doi.org/10.3390/jcm8101642

Chicago/Turabian Style

Veulemans, Verena, Amin Polzin, Oliver Maier, Kathrin Klein, Georg Wolff, Katharina Hellhammer, Shazia Afzal, Kerstin Piayda, Christian Jung, Ralf Westenfeld, Alexander Blehm, Artur Lichtenberg, Malte Kelm, and Tobias Zeus. 2019. "Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis Undergoing Transcatheter Valve Replacement" Journal of Clinical Medicine 8, no. 10: 1642. https://doi.org/10.3390/jcm8101642

Find Other Styles

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Metrics

Abstract views Pdf views Html views

Article Menu

Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis Undergoing Transcatheter Valve Replacement

Abstract

Share and Cite

Article Metrics

Article Access Statistics

Article Access Map by Country/Region

Further Information

Guidelines

MDPI Initiatives

Follow MDPI