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Abstract 14347: A New Risk Model for Prognostic Prediction After Transcatheter Aortic Valve Replacement

Maeda, Koichi ; Kuratani, Toru ; Pak, Kyongsun ; Shimamura, Kazuo ; Yamamoto, Junpei ; Mizote, Isamu ; Ichibori, Yasuhiro ; Toda, Koichi ; Sakata, Yasushi ; Sawa, Yoshiki

Circulation, 2018, Vol.138(Suppl_1 Suppl 1), pp.A14347-A14347 [Periódico revisado por pares]

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  • Título:
    Abstract 14347: A New Risk Model for Prognostic Prediction After Transcatheter Aortic Valve Replacement
  • Autor: Maeda, Koichi ; Kuratani, Toru ; Pak, Kyongsun ; Shimamura, Kazuo ; Yamamoto, Junpei ; Mizote, Isamu ; Ichibori, Yasuhiro ; Toda, Koichi ; Sakata, Yasushi ; Sawa, Yoshiki
  • É parte de: Circulation, 2018, Vol.138(Suppl_1 Suppl 1), pp.A14347-A14347
  • Descrição: Introduction: Current recommendations for transcatheter aortic valve replacement (TAVR) by the guidelines are that TAVR should be carried out in patients with a life expectancy >1 year. Furthermore, patients with a life expectancy >2 year are enrolled in the recent low-risk trials. However, it is challenging to predict the patients’ life expectancy because it is associated with various factors including frailty and nutritional status.Hypothesis: A new risk model can predict prognosis of patients after TAVR.Methods: 388 patients undergoing TAVR between Oct. 2009 and Aug. 2016 were randomly divided into 2 groups with 2:1 ratio (259 as training and 129 as validation cohorts). Using 94 baseline factors in the training cohorts, possible scoring models were developed by Cox proportional hazard regression model with the overall survival as the endpoint. Cross-validated 5-year C-statistics was calculated to evaluate the accuracy of the model.Results: Among 94 baseline factors, 12 factors were finally determined (5-year C-statistics in the training cohort: 0.709); age, gender, body mass index (BMI), ejection fraction (EF), % vital capacity (%VC), forced expiratory volume 1.0(sec) % (FEV1.0%), albumin, hemoglobin, creatine, platelet, creatine kinase (CK), and prothrombin time-international normalized ratio (PT-INR)). The cross-validated 1-, 3- and 5-year C-statistics in the validation cohort were 0.792, 0.758, and 0.778, respectively. Furthermore, calibration plots in the validation cohort revealed that the actual survivals until 5 years were well predicted (r=0.962; Figure).Conclusions: The new survival prediction model for AS patients would be helpful in appropriate guidance for the decision to implement TAVR.

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