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Assessment of TVT and STS Risk Score Performances in Patients Undergoing Transcatheter Aortic Valve Replacement.
Al-Azizi, Karim; Shih, Emily; DiMaio, J Michael; Squiers, John J; Moubarak, Ghadi; Kluis, Austin; Banwait, Jasjit K; Ryan, William H; Szerlip, Molly I; Potluri, Srinivasa P; Hamandi, Mohanad; Lanfear, Allison T; Meidan, Talia G; Stoler, Robert C; Mixon, Timothy A; Krueger, Anita R; Mack, Michael J.
Affiliation
  • Al-Azizi K; Department of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas.
  • Shih E; Department of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas.
  • DiMaio JM; Baylor Scott & White Research Institute, Plano, Texas.
  • Squiers JJ; Department of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas.
  • Moubarak G; Baylor Scott & White Research Institute, Plano, Texas.
  • Kluis A; Department of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas.
  • Banwait JK; Baylor Scott & White Research Institute, Plano, Texas.
  • Ryan WH; Baylor Scott & White Research Institute, Plano, Texas.
  • Szerlip MI; Baylor Scott & White Research Institute, Plano, Texas.
  • Potluri SP; Department of Cardiothoracic Surgery, Baylor Scott & White The Heart Hospital, Plano, Texas.
  • Hamandi M; Department of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas.
  • Lanfear AT; Department of Cardiology, Baylor Scott & White The Heart Hospital, Plano, Texas.
  • Meidan TG; Baylor Scott & White Research Institute, Plano, Texas.
  • Stoler RC; Baylor Scott & White Research Institute, Plano, Texas.
  • Mixon TA; Baylor Scott & White Research Institute, Plano, Texas.
  • Krueger AR; Department of Cardiology, Baylor University Medical Center, Dallas, Texas.
  • Mack MJ; Department of Cardiology, Baylor Scott & White Medical Center-Temple, Temple, Texas.
J Soc Cardiovasc Angiogr Interv ; 2(3): 100600, 2023.
Article in En | MEDLINE | ID: mdl-39130722
ABSTRACT

Background:

The Society of Thoracic Surgeons (STS) score has been used to risk stratify patients undergoing transcatheter aortic valve replacement (TAVR). The Transcatheter Valve Therapy (TVT) score was developed to predict in-hospital mortality in high/prohibitive-risk patients. Its performance in low and intermediate-risk patients is unknown. We sought to compare TVT and STS scores' ability to predict clinical outcomes in all-surgical-risk patients undergoing TAVR.

Methods:

Consecutive patients undergoing TAVR from 2012-2020 within a large health care system were retrospectively reviewed and stratified by STS risk score. Predictive abilities of TVT and STS scores were compared using observed-to-expected mortality ratios (OE) and area under the receiver operating characteristics curves (AUCs) for 30-day and 1-year mortality.

Results:

We assessed a total of 3270 patients (mean age 79 ± 9 years, 45% female), including 191 (5.8%) low-risk, 1093 (33.4%) intermediate-risk, 1584 (48.4%) high-risk, and 402 (5.8%) inoperable. Mean TVT and STS scores were 3.5% ± 2.0% and 6.1% ± 4.3%, respectively. Observed 30-day and 1-year mortality were 2.8% (92/3270; OE TVT 0.8 ± 0.16 vs STS 0.46 ± 0.09), and 13.2% (432/3270), respectively. In the all-comers population, both TVT and STS risk scores showed poor prediction of 30-day (AUC TVT 0.68 [0.62-0.74] vs STS 0.64 [0.58-0.70]), and 1-year (AUC TVT 0.65 [0.62-0.58] vs STS 0.65 [0.62-0.58]) mortality. After stratifying by surgical risk, discrimination of the TVT and STS scores remained poor in all categories at 30 days and 1 year.

Conclusions:

An updated TAVR risk score with improved predictive ability across all-surgical-risk categories should be developed based on a larger national registry.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: J Soc Cardiovasc Angiogr Interv Year: 2023 Document type: Article Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: J Soc Cardiovasc Angiogr Interv Year: 2023 Document type: Article Country of publication: United States