Comparison of mid-term results of transcatheter aortic valve implantation in high-risk patients with logistic EuroSCORE ≥ 20% or < 20.
BACKGROUND
Transcatheter aortic valve implantation (TAVI) is an established treatment method in selected high-risk patients with severe aortic stenosis. However, data on which patients gain most benefit from this procedure is still limited. According to the European consensus document, TAVI is recommended for high-risk patients with logistic EuroSCORE (log ES) ≥ 20%. To date, little is known about TAVI outcomes in patients with log ES < 20%.


AIM
To evaluate outcomes of TAVI in high-risk patients with log ES ≥ 20% in comparison with high-risk patients with log ES < 20%.


METHODS AND RESULTS
Of 93 patients who underwent TAVI at our institution between January 2009 and December 2011, we identified 59 (63.4%) patients with log ES ≥ 20% (Group 1) and 34 (36.6%) patients with log ES < 20% (Group 2). The mean log ES was 30.9 ± 9.7% in Group 1 and 12.7 ± 4.9% in Group 2 (p < 0.01). Significant differences were found between the two groups in regard to age (82.9 ± 5.9 vs. 78.7 ± 7.8 years, p = 0.001), left ventricular ejection fraction (51.5 ± 14% vs. 60.4 ± 9.6%, p = 0.002), pulmonary artery systolic pressure (56 ± 11 vs. 49 ± 10.6 mm Hg, p = 0.02), and glomerular filtration rate (51.3 ± 18.4 vs. 60.6 ± 16.6 mL/min/m2, p = 0.02). Survival rates at 1 and 2 years were 76.6% and 69.0% in Group 1 and 89.0% and 83.6% in Group 2 (p = NS). However, cardiovascular mortality at 1 and 2 years was higher in Group 1 compared to Group 2 (21.4% and 28.6% vs. 8.1% and 10.8% in Groups 1 and 2, respectively).


CONCLUSIONS
The results of this study demonstrate that at 2 years of follow-up, TAVI in high-risk patients with log ES ≥ 20% was associated with a higher cardiovascular mortality compared to high-risk patients with log ES < 20%.
['Chmielak|Zbigniew|Z|', 'Witkowski|Adam|A|', 'Dąbrowski|Maciej|M|', 'Demkow|Marcin|M|', 'Kuśmierski|Krzysztof|K|', 'Sitkowska|Ewa|E|', 'Jastrzębski|Jan|J|', 'Szymański|Piotr|P|', 'Hryniewiecki|Tomasz|T|', 'Czerwińska|Katarzyna|K|', 'Stępińska|Janina|J|']
D000368:Aged D000369:Aged, 80 and over D001024:Aortic Valve Stenosis D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D015996:Survival Rate D065467:Transcatheter Aortic Valve Replacement D016896:Treatment Outcome
transcatheter aortic valve implantation logistic EuroSCORE aortic valve stenosis