Validation of cardiac damage classification and addition of albumin in a large cohort of patients undergoing transcatheter aortic valve replacement.

Autor: Berkovitch A; Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Barbash IM; Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Finkelstein A; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Tel Aviv Medical Center, Tel Aviv, Israel., Assali AR; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Rabin Medical Center, Petach-Tikva, Israel., Danenberg H; The Heart Institute, Hadassah Ein-Karem Medical Center, The Hebrew University, Jerusalem, Israel., Fefer P; Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Maor E; Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Zhitomirsky S; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Tel Aviv Medical Center, Tel Aviv, Israel., Orvin K; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Rabin Medical Center, Petach-Tikva, Israel., Zekry SB; Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Steinvil A; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Tel Aviv Medical Center, Tel Aviv, Israel., Barsheshet A; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Rabin Medical Center, Petach-Tikva, Israel., Halkin A; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Tel Aviv Medical Center, Tel Aviv, Israel., Guetta V; Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel., Kornowski R; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel; Division of Cardiology, Rabin Medical Center, Petach-Tikva, Israel., Segev A; Division of Cardiology, Leviev Heart and Vascular Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. Electronic address: Amit.Segev@sheba.health.gov.il.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2020 Apr 01; Vol. 304, pp. 23-28. Date of Electronic Publication: 2020 Jan 15.
DOI: 10.1016/j.ijcard.2020.01.031
Abstrakt: Aims: We aimed to validate a new scoring system based on extent of cardiac damage for risk stratification in patients undergoing transcatheter aortic valve replacement (TAVR) in a real-world cohort and to examine the addition of baseline albumin in risk assessment.
Methods and Results: We investigated 2608 patients undergoing TAVR. Subjects were divided into five groups based on their echocardiography findings. Patients were further assessed by incorporating baseline albumin. Multivariable analysis demonstrated that each increase in stage was associated with significant increased risk of 1-year mortality (HR 1.37, 95%CI 1.23-1.54, p < .001). Among patients at increased stage (3-4), incorporation of baseline of albumin identified the highest risk group, such that each 1 decrement in albumin levels was associated with more than triple increase in mortality among patients at stage 3 and 4 (HR 2.77, 95% CI 1.48-5.18, p-value = .001).
Conclusions: Cardiac damage classification is validated in a real-world cohort of patients undergoing TAVR. Incorporation of low baseline albumin may further identify patients at the highest risk group.
Condensted Abstract: We evaluated 2608 patients undergoing transcatheter aortic valve replacement (TAVR) in order to validate a new scoring system dividing patients in to 5 stages (0-4) based on extent of cardiac damage. Patients were further assessed by incorporating baseline albumin. Multivariable analysis demonstrated that each increase in stage was associated with significant increased risk of 1-year mortality. Furthermore, among patients at increased stage (3-4), incorporation of baseline of albumin identified the highest risk group, such that each 1 decrement in albumin levels was associated with more than triple increase in mortality among patients at stage 3 and 4.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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