A Risk Model for 1-Year Mortality After Transcatheter Aortic Valve Replacement From the J-TVT Registry

Koichi Maeda, Hiraku Kumamaru, Shun Kohsaka, Kazuo Shimamura, Isamu Mizote, Kizuku Yamashita, Ai Kawamura, Takashi Mukai, Daisuke Nakamura, Yasuharu Takeda, Hideyuki Shimizu, Yasushi Sakata, Toru Kuratani, Shigeru Miyagawa, Yoshiki Sawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Although transcatheter aortic valve replacement (TAVR) has demonstrated favorable outcomes in randomized studies, there remains a sizable group of patients in whom TAVR may be futile. Characterizing the survival rate in a wide array of patients undergoing TAVR can help develop effective strategies for improving the allocation of medial resources. Objectives: The aim of this study was to develop a risk model to estimate 1-year mortality after TAVR from a representative nationwide registry in Japan. Methods: The J-TVT (Japan Transcatheter Valve Therapies) registry contains complete data, including 1-year outcomes, on patients undergoing TAVR in Japan. A total of 17,655 patients underwent TAVR between 2013 and 2018. They were randomly divided into 2 groups in a 7:3 ratio to form a derivation cohort of 12,316 patients and a validation cohort of 5,339 patients. A risk model was constructed for 1-year mortality in the derivation cohort, and its discrimination and calibration were assessed in the validation cohort. Results: The mean age of all registered patients was 84.4 years, and 68.8% were women. The mean body size area was 1.43 m2, and the mean Society of Thoracic Surgeons Predicted Risk of Mortality score was 7.3%. The estimated 1-year survival was 91.8%; 202 and 1,316 deaths were observed at 30 days and 1 year, respectively; The estimated C index for the developed model was 0.733 (95% CI: 0.709-0.757) in the validation cohort, with good calibration. Conclusions: A prediction model for 1-year survival following TAVR derived from a national clinical database performed well and should aid physicians managing TAVR patients.

Original languageEnglish
Pages (from-to)635-644
Number of pages10
JournalJACC: Asia
Volume2
Issue number5
DOIs
Publication statusPublished - 2022 Oct

Keywords

  • prediction model
  • registry
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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