Germany: People who underwent transcatheter aortic valve replacement (TAVR) with higher-stage cardiac damage were more likely to die within 1 year, according to results from a retrospective multicenter study. The study was published in Catheterization & Cardiovascular Interventions on 21 August 2022.
A large number of severe aortic stenosis (AS) patients who undergo TAVR suffer from extra-aortic cardiac damage. Not many studies have investigated strategies for quantifying cardiac damage and dividing patients into different risk groups. Considering this, Jasmin Shamekhi, Department of Medicine II, Heart Center, University Hospital Bonn, Bonn, Germany, and colleagues aimed to provide a user-friendly simplified staging system based on the proposed classification system of Généreux et al. as a tool for more easy evaluation of the prognosis of patients undergoing TAVR. In addition, the researchers analyzed changes in cardiac damage after TAVR.
For this purpose, the researchers used pre- and postprocedural transthoracic echocardiography for assessing cardiac damage in patients who underwent TAVR at the Heart Center Bonn or Düsseldorf. According to the severity of their baseline cardiac damage, patients were assigned to the staging system proposed by Généreux et al.
A simple staging system was created based on the established system to facilitate improved applicability. Finally, a comparison was made of clinical outcomes between the groups, and changes in cardiac damage after TAVR were evaluated. The researchers included a total of 933 TAVR patients in the study.
Key findings include:
A significant association was found between cardiac damage and 1-year all-cause mortality (stage 0: 0% vs. stage 1: 3% vs. stage 2: 6.6%).
In multivariate analysis, cardiac damage was an independent predictor of 1-year all-cause mortality (hazard ratio: 2.0).
The researchers wrote in their conclusion, "cardiac damage in patients undergoing TAVR is associated with enhanced mortality. A simplified staging system would be useful for identifying patients at high risk for an adverse outcome."
Reference:
The study titled, "A simplified cardiac damage staging predicts the outcome of patients undergoing TAVR—A multicenter analysis," was published in Catheterization & Cardiovascular Interventions.
DOI: https://doi.org/10.1002/ccd.30368