A Score to Assess Mortality After Percutaneous Mitral Valve Repair.
J Am Coll Cardiol
; 79(6): 562-573, 2022 02 15.
Article
en En
| MEDLINE
| ID: mdl-35144748
ABSTRACT
BACKGROUND:
Risk stratification for transcatheter edge-to-edge mitral valve repair (TEER) is paramount in the decision-making process for treating severe mitral regurgitation (MR).OBJECTIVES:
This study sought to create and validate a user-friendly score (MitraScore) to predict the risk of mortality in patients undergoing TEER.METHODS:
The derivation cohort was based on a multicentric international registry that included 1,119 patients referred for TEER between 2012 and 2020. Score discrimination was assessed using Harrell's c-statistic, and the calibration was evaluated with the Gronnesby and Borgan goodness-of-fit test. An external validation was carried out in 725 patients from the GIOTTO registry.RESULTS:
After multivariate analysis, we identified 8 independent predictors of mortality during the follow-up (2.1 ± 1.8 years) age ≥75 years, anemia, glomerular filtrate rate <60 mL/min/1.73 m2, left ventricular ejection fraction <40%, peripheral artery disease, chronic obstructive pulmonary disease, high diuretic dose, and no therapy with renin-angiotensin system inhibitors. The MitraScore was derived by assigning 1 point to each independent predictor. The c-statistic was 0.70. Per each point of the MitraScore, the relative risk of mortality increased by 55% (HR 1.55; 95% CI 1.44-1.67; P < 0.001). The discrimination and calibration for mortality prediction was better than those of EuroSCORE II (c-statistic 0.61) or Society of Thoracic Surgeons score (c-statistic 0.57). The MitraScore maintained adequate performance in the validation cohort (c-statistic 0.66). The score was also predictive for heart failure rehospitalization and was correlated with the probability of clinical improvement.CONCLUSIONS:
The MitraScore is a simple prediction algorithm for the prediction of follow-up mortality in patients treated with TEER.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Complicaciones Posoperatorias
/
Cateterismo Cardíaco
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Sistema de Registros
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Implantación de Prótesis de Válvulas Cardíacas
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Válvula Mitral
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Insuficiencia de la Válvula Mitral
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Am Coll Cardiol
Año:
2022
Tipo del documento:
Article