RT Journal Article
SR Electronic
T1 Does the CHA<sub>2</sub>DS<sub>2</sub>-Vasc score predict procedural and short-term outcomes in patients undergoing transcatheter aortic valve implantation?
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000170
DO 10.1136/openhrt-2014-000170
VO 2
IS 1
A1 Tahir Hamid
A1 Tawfiq R Choudhury
A1 Simon G Anderson
A1 Izhar Hashmi
A1 Saqib Chowdhary
A1 David Hesketh Roberts
A1 Douglas G Fraser
A1 Ragheb Hasan
A1 Vaikom S Mahadevan
A1 Richard Levy
YR 2015
UL http://openheart.bmj.com/content/2/1/e000170.abstract
AB Background Transcatheter aortic valve implantation (TAVI) is associated with periprocedural and postprocedural morbidity and mortality. Currently, there is a paucity of risk stratification models for potential TAVI candidates. We employed the CHA2DS2-Vasc score to quantify the risk of 30-day mortality and morbidity in patients undergoing TAVI.Methods and results A retrospective analysis of registry data for consecutive patients undergoing TAVI at 3 tertiary centres in Northwest England between 2008 and 2013. The CHA2DS2-Vasc score and its modification—the R2CHA2DS2-Vasc score, which includes pre-existing renal impairment and pre-existing conduction abnormality (right bundle branch block/left bundle branch block, RBBB/LBBB)—were calculated for all patients. A total of 313 patients with a mean age of 80 (79.1–80.8) years underwent TAVI. The implanted devices were either the CoreValve or the Edwards-SAPIEN prosthesis. The 30-day mortality was 14.3% in those with a CHA2DS2-Vasc score ≥6, whereas it was only 6.2% in those with a score &lt;6 (p=0.04). Using the R2-CHA2DS2-Vasc score, the difference was more pronounced with a 30-day mortality of 22.6% in those patients with an R2-CHA2DS2-Vasc score ≥7 compared to 6.0% in those with a R2-CHA2DS2-Vasc score &lt;7 (p=0.001). In multivariable Cox regression analyses, there was a significant and independent relationship between the CHA2DS2-Vasc score (hazard ratio (HR)= 2.71, (1.01 to 7.31); p&lt;0.05) and the modified R2CHA2DS2-Vasc score (HR=4.27 (1.51 to 12.07); p=0.006) with 30-day mortality.Conclusions Our study demonstrates the potential use of the CHA2DS2-Vasc or the R2CHA2DS2-Vasc score to quantify the risk of mortality in patients undergoing TAVI. This could have significant implications in terms of clinical as well as patients’ decision-making.