The Revised EuroSCORE II for the Prediction of Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation

Overview

Journal Clin Res Cardiol

Specialty Cardiology & Vascular Diseases

Date 2013 Jul 24

PMID 23877301

Citations 15

Authors

Alexander Sedaghat

Jan-Malte Sinning

Mariuca Vasa-Nicotera

Alexander Ghanem

Christoph Hammerstingl

Eberhard Grube

Georg Nickenig

Nikos Werner

Affiliations

Soon will be listed here.

Abstract

Background: The assessment of procedural risk is crucial in patients with severe symptomatic aortic stenosis. Logistic EuroSCORE and STS score are currently used to estimate procedural risk and mortality for surgical and transcatheter aortic valve implantation (TAVI). The recently published EuroSCORE II might provide a helpful tool.

Methods: The new EuroSCORE II was calculated in 206 patients undergoing transfemoral TAVI and compared to the established logistic EuroSCORE and STS mortality score. Discriminative power and calibration of each test was statistically evaluated.

Results: 30-day and 1-year mortality rates were 6.8 % (14/206) and 27.2 % (56/206). In-hospital mortality rate was 29.2 ± 17.8 % with logistic EuroSCORE, 9.5 ± 6.8 % with STS score, and 9.22 ± 7.12 % with EuroSCORE II: Logistic EuroSCORE and EuroSCORE II were significantly increased in non-survivors compared to survivors at 30 days and at 1 year. EuroSCORE II and STS score (r = 0.49, p < 0.001) showed moderate correlation, whereas strong correlation was found between EuroSCORE II and logistic EuroSCORE (r = 0.71, p < 0.001). ROC curve analyses for the prediction of 30-day mortality (AUC 0.79 vs. 0.69 vs. 0.71) and 1-year mortality (AUC 0.72 vs. 0.70 vs. 0.70) were performed. Statistical comparison revealed no difference between the AUCs (p > 0.05).

Conclusion: In percutaneous TAVI patients, 30-day mortality was best approximated by the new EuroSCORE II, whereas the logistic EuroSCORE best reflected 1-year mortality. However, EuroSCORE II does not provide additional prognostic information beyond the established logistic EuroSCORE. For more exact risk prediction in TAVI, a distinct TAVI risk score would be desirable.

Citing Articles

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Low levels of circulating methylated IRX3 are related to worse outcome after transcatheter aortic valve implantation in patients with severe aortic stenosis.

Kanwischer L, Xu X, Saifuddin A, Maamari S, Tan X, Alnour F Clin Epigenetics. 2023; 15(1):149.

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Temporal trends of TAVI treatment characteristics in high volume centers in Germany 2013-2020.

Mauri V, Abdel-Wahab M, Bleiziffer S, Veulemans V, Sedaghat A, Adam M Clin Res Cardiol. 2021; 111(8):881-888.

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Kidney injury as post-interventional complication of TAVI.

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Clinical value of the 20% logistic EuroSCORE cut-off for selecting TAVI candidates: a single-centre cohort study analysis.

Imnadze G, Hofmann S, Billion M, Ferdosi A, Kowalski M, Rajab E Open Heart. 2020; 7(1):e001194.

PMID: 32153791 PMC: 7046969. DOI: 10.1136/openhrt-2019-001194.

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