TCT-710 Difference of Short Term Outcome in Low, Intermediate and High risk Patient in TAVI

  • Mitsuhashi H
  • Ko D
  • Radhakrishnan S
  • et al.
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Abstract

Background: Short term outcome of TAVI in intermediate and low risk patient is not well known. We performed a cross sectional study to investigate short term mortality and major cardiovascular event (MACE) in low and intermediate risk patients, and compared to those in high risk patients. Methods: Consecutive 125 patients who received TAVI were included in the study. High, intermediate and low risk for surgical aortic valve replacement (S-AVR) was defined as STS score was 10 or higher, 4-9.99 and less than 4, respectively. MACE was defined as death, stroke, myocardial infarction, unplanned open chest or peripheral vascular repair/intervention, acute kidney injury and lethal bleeding according to the VARC definition. Odds ratios (ORs) of in hospital mortality andMACE in intermediate and low risk patients compared to high risk patients were calculated with multivariate logistic regression analysis adjusted for patient background. Results: 35, 70 and 20 patients were included in high, intermediate and low risk group. Mortality was observed in 3 (8.6%), 2 (2.9%) and 0 (0%) patients and mortality rate in each risk group was same or lower than bottom level of STS score defined in each risk stratification (10%, 4% and 0%). MACE was observed in 14 (40.0%), 12 (17.1%) and 2 (10.0%) patients. ORs of mortality in intermediate and low risk group were 0.53 (95%CI: 0.02-12.3, p = 0.70) and <0.55 (95%CI: 0.00-0.00, p < 0.23). ORs of MACE were 0.27 (95% CI: 0.10-0.74, p = 0.011) and 0.27 (95% CI: 0.05- 1.54, p = 0.14). No significant difference in mortality and MACE between intermediate and low risk group (p = 1.00 and p = 0.73, respectively). Conclusions: Compared to surgical risk, mortality rate was lower especially in high and intermediate risk group in TAVI. Compared to high risk patients, intermediate and low risk patients showed lower risk for in hospital mortality and MACE although difference did not reach statistical significance due to lack of sample size. Intermediate and low risk patients showed similar short term outcome after TAVI. Result of the study indicated a possibility that TAVI is effective especially for intermediate risk patient for S-AVR.

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Mitsuhashi, H., Ko, D., Radhakrishnan, S., & Fremes, S. (2013). TCT-710 Difference of Short Term Outcome in Low, Intermediate and High risk Patient in TAVI. Journal of the American College of Cardiology, 62(18), B217. https://doi.org/10.1016/j.jacc.2013.08.1462

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