Post procedural risk assessment in patients undergoing trans aortic valve implantation according to the age, creatinine, and ejection fraction-7 score: Advantages of age, creatinine, and ejection fraction-7 in stratification of post-procedural outcome.


Journal

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139

Informations de publication

Date de publication:
01 01 2019
Historique:
received: 01 02 2018
revised: 30 06 2018
accepted: 12 07 2018
pubmed: 1 10 2018
medline: 21 1 2020
entrez: 1 10 2018
Statut: ppublish

Résumé

Post-procedural risk stratification based on renal function after trans aortic valve implantation (TAVI) was assessed by means of a modified age, creatinine, and ejection fraction (ACEF) score using the lowest glomerular filtration rate (GFR), obtained within 1 week after valve implantation. We refer to the score as ACEF-7 score. The Zurich- and Cardiocentro Ticino TAVI-Cohorts comprised of 424, and 137 patients, who were not on hemodialysis and had already survived the first post-procedural week. Zurich patients were stratified into tertiles of ACEF-7 score (ACEF-7 Six months (18.1% vs. 6.3% vs. 2.9% P < 0.001) and 1-year all-cause mortality (24.3% vs. 12.7% % vs. 5.8%, P < 0.001), as well as the composite of death or rehospitalization (35% vs. 20% vs. 11% P < 0.001) occurred significantly more frequently in the ACEF-7 Post-procedural risk stratification using the simple ACEF-7 score significantly better predicted long-term outcome than commonly used risk-scores. Practical implications could include contrast sparing and renal protection in high-risk patients, emphasizing the importance of preventative measures.

Sections du résumé

BACKGROUND
Post-procedural risk stratification based on renal function after trans aortic valve implantation (TAVI) was assessed by means of a modified age, creatinine, and ejection fraction (ACEF) score using the lowest glomerular filtration rate (GFR), obtained within 1 week after valve implantation. We refer to the score as ACEF-7 score.
METHODS
The Zurich- and Cardiocentro Ticino TAVI-Cohorts comprised of 424, and 137 patients, who were not on hemodialysis and had already survived the first post-procedural week. Zurich patients were stratified into tertiles of ACEF-7 score (ACEF-7
RESULTS
Six months (18.1% vs. 6.3% vs. 2.9% P < 0.001) and 1-year all-cause mortality (24.3% vs. 12.7% % vs. 5.8%, P < 0.001), as well as the composite of death or rehospitalization (35% vs. 20% vs. 11% P < 0.001) occurred significantly more frequently in the ACEF-7
CONCLUSION
Post-procedural risk stratification using the simple ACEF-7 score significantly better predicted long-term outcome than commonly used risk-scores. Practical implications could include contrast sparing and renal protection in high-risk patients, emphasizing the importance of preventative measures.

Identifiants

pubmed: 30269398
doi: 10.1002/ccd.27806
doi:

Substances chimiques

Biomarkers 0
Creatinine AYI8EX34EU

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

141-148

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2018 Wiley Periodicals, Inc.

Auteurs

Andrea Denegri (A)

University Heart Center, University Hospital, Zurich, Switzerland.
Cardiocentro Lugano, University of Zurich, Lugano, Switzerland.
Cardiology Unit and Laboratory of Cardiovascular Biology, IRCCS-AOU San Martino-IST University of Genova, Genoa, Italy.

Roxana Mehran (R)

Mount Sinai Medical Center, New York, New York.

Erik Holy (E)

University Heart Center, University Hospital, Zurich, Switzerland.

Maurizio Taramasso (M)

University Heart Center, University Hospital, Zurich, Switzerland.

Elena Pasotti (E)

Cardiocentro Lugano, University of Zurich, Lugano, Switzerland.

Giovanni Pedrazzini (G)

Cardiocentro Lugano, University of Zurich, Lugano, Switzerland.

Tiziano Moccetti (T)

Cardiocentro Lugano, University of Zurich, Lugano, Switzerland.

Francesco Maisano (F)

University Heart Center, University Hospital, Zurich, Switzerland.

Fabian Nietlispach (F)

University Heart Center, University Hospital, Zurich, Switzerland.

Slayman Obeid (S)

University Heart Center, University Hospital, Zurich, Switzerland.

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Classifications MeSH