Predictors of Poor Outcomes After Transcatheter Aortic Valve Replacement

DOI Web Site 被引用文献3件
  • Suzanne V. Arnold
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Matthew R. Reynolds
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Yang Lei
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Elizabeth A. Magnuson
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Ajay J. Kirtane
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Susheel K. Kodali
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Alan Zajarias
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Vinod H. Thourani
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Philip Green
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Josep Rodés-Cabau
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Nirat Beohar
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Michael J. Mack
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • Martin B. Leon
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...
  • David J. Cohen
    From Saint Luke’s Mid America Heart Institute, Kansas City, MO (S.V.A., Y.L., E.A.M., D.J.C.); University of Missouri-Kansas City, Kansas City, MO (S.V.A., E.A.M., D.J.C.); Harvard Clinical Research Institute, Boston, MA (M.R.R.); Columbia-Presbyterian Hospital, New York, NY (A.J.K., S.K.K., P.G., M.B.L.); Washington University, St. Louis, MO (A.Z.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Laval University, Quebec, Canada (J.R.-C.); Columbia University Division of Cardiology at...

書誌事項

タイトル別名
  • Results From the PARTNER (Placement of Aortic Transcatheter Valve) Trial

説明

<jats:sec> <jats:title>Background—</jats:title> <jats:p>Transcatheter aortic valve replacement (TAVR) is a less invasive option for treatment of high-risk patients with severe aortic stenosis. We sought to identify patients at high risk for poor outcome after TAVR using a novel definition of outcome that integrates quality of life with mortality.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> Among 2137 patients who underwent TAVR in the PARTNER (Placement of Aortic Transcatheter Valve) trial or its associated continued access registry, quality of life was assessed with the Kansas City Cardiomyopathy Questionnaire–Overall Summary Scale (KCCQ-OS; range 0–100, where a higher score equates to a better quality of life) at baseline and at 1, 6, and 12 months after TAVR. A poor 6-month outcome (defined as death, KCCQ-OS score <45, or ≥10-point decrease in KCCQ-OS score compared with baseline) occurred in 704 patients (33%). Using a split-sample design, we developed a multivariable model to identify a parsimonious set of covariates to identify patients at high risk for poor outcome. The model demonstrated moderate discrimination ( <jats:italic>c</jats:italic> -index=0.66) and good calibration with the observed data, performed similarly in the separate validation cohort ( <jats:italic>c</jats:italic> -index=0.64), and identified 211 patients (10% of the population) with a ≥50% likelihood of a poor outcome after TAVR. A second model that explored predictors of poor outcome at 1 year identified 1102 patients (52%) with ≥50% likelihood and 178 (8%) with ≥70% likelihood of a poor 1-year outcome after TAVR. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>Using a large, multicenter cohort, we have developed and validated predictive models that can identify patients at high risk for a poor outcome after TAVR. Although model discrimination was moderate, these models may help guide treatment choices and offer patients realistic expectations of outcomes based on their presenting characteristics.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trial Registration—</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: NCT00530894. </jats:p> </jats:sec>

収録刊行物

  • Circulation

    Circulation 129 (25), 2682-2690, 2014-06-24

    Ovid Technologies (Wolters Kluwer Health)

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