Prognostic value of liver dysfunction assessed by MELD-XI scoring system in patients undergoing transcatheter aortic valve implantation

OCEAN-TAVI investigators

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background There are limited data regarding the influence of liver dysfunction on outcomes of transcatheter aortic valve implantation (TAVI). Model for End-stage Liver Disease eXcluding International normalized ratio (MELD-XI) score, which was originally developed for patients with cirrhosis awaiting liver transplantation, has been reported as a predictor of heart disease. The aim of this study was to investigate the prognostic value of MELD-XI score for patients undergoing TAVI. Methods Data from the prospectively maintained Optimized transCathEter vAlvular iNtervention (OCEAN-TAVI) multicenter registry were collected in 749 patients who underwent TAVI between October 2013 and August 2015. MELD-XI score was calculated as follows: 11.76 × Ln (creatinine) + 5.11 × Ln (total bilirubin) + 9.44. Patients were categorized based on MELD-XI score > 10 or ≤ 10, and compared with regard to clinical characteristics and outcomes of TAVI. Results Higher MELD-XI score was associated with lower 30-day survival (95.6% vs 98.5%, P = 0.03). Kaplan–Meier analysis revealed that higher MELD-XI score also was associated with lower 6-month survival (P < 0.01). Multivariate Cox regression analysis showed that MELD-XI score was an independent predictor of 6-month cumulative mortality. Receiver operating characteristic analysis revealed that MELD-XI score showed better accuracy in predicting 6-month mortality compared with Logistic European System for Cardiac Operative Risk Evaluation, European System for Cardiac Operative Risk Evaluation II, and Society of Thoracic Surgeons scores (area under the curve = 0.67, 0.58, 0.57, and 0.60, respectively). Conclusion Evaluation of liver dysfunction according to MELD-XI score provides additional risk information for patients undergoing TAVI.

Original languageEnglish
Pages (from-to)648-653
Number of pages6
JournalInternational Journal of Cardiology
Volume228
DOIs
Publication statusPublished - 2017 Feb 1

Fingerprint

Liver Diseases
End Stage Liver Disease
International Normalized Ratio
Survival
Mortality
Bilirubin
ROC Curve
Liver Transplantation
Area Under Curve
Registries
Transcatheter Aortic Valve Replacement
Heart Diseases
Creatinine
Fibrosis
Regression Analysis

Keywords

  • Liver dysfunction
  • MELD-XI score
  • Severe symptomatic aortic stenosis
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic value of liver dysfunction assessed by MELD-XI scoring system in patients undergoing transcatheter aortic valve implantation. / OCEAN-TAVI investigators.

In: International Journal of Cardiology, Vol. 228, 01.02.2017, p. 648-653.

Research output: Contribution to journalArticle

@article{ecd7859c6c3a4cd8995fc8c773c59943,
title = "Prognostic value of liver dysfunction assessed by MELD-XI scoring system in patients undergoing transcatheter aortic valve implantation",
abstract = "Background There are limited data regarding the influence of liver dysfunction on outcomes of transcatheter aortic valve implantation (TAVI). Model for End-stage Liver Disease eXcluding International normalized ratio (MELD-XI) score, which was originally developed for patients with cirrhosis awaiting liver transplantation, has been reported as a predictor of heart disease. The aim of this study was to investigate the prognostic value of MELD-XI score for patients undergoing TAVI. Methods Data from the prospectively maintained Optimized transCathEter vAlvular iNtervention (OCEAN-TAVI) multicenter registry were collected in 749 patients who underwent TAVI between October 2013 and August 2015. MELD-XI score was calculated as follows: 11.76 × Ln (creatinine) + 5.11 × Ln (total bilirubin) + 9.44. Patients were categorized based on MELD-XI score > 10 or ≤ 10, and compared with regard to clinical characteristics and outcomes of TAVI. Results Higher MELD-XI score was associated with lower 30-day survival (95.6{\%} vs 98.5{\%}, P = 0.03). Kaplan–Meier analysis revealed that higher MELD-XI score also was associated with lower 6-month survival (P < 0.01). Multivariate Cox regression analysis showed that MELD-XI score was an independent predictor of 6-month cumulative mortality. Receiver operating characteristic analysis revealed that MELD-XI score showed better accuracy in predicting 6-month mortality compared with Logistic European System for Cardiac Operative Risk Evaluation, European System for Cardiac Operative Risk Evaluation II, and Society of Thoracic Surgeons scores (area under the curve = 0.67, 0.58, 0.57, and 0.60, respectively). Conclusion Evaluation of liver dysfunction according to MELD-XI score provides additional risk information for patients undergoing TAVI.",
keywords = "Liver dysfunction, MELD-XI score, Severe symptomatic aortic stenosis, Transcatheter aortic valve implantation",
author = "{OCEAN-TAVI investigators} and Takahide Arai and Fumiaki Yashima and Ryo Yanagisawa and Makoto Tanaka and Hideyuki Shimizu and Keiichi Fukuda and Yusuke Watanabe and Toru Naganuma and Motoharu Araki and Norio Tada and Futoshi Yamanaka and Shinichi Shirai and Masanori Yamamoto and Kentaro Hayashida",
year = "2017",
month = "2",
day = "1",
doi = "10.1016/j.ijcard.2016.11.096",
language = "English",
volume = "228",
pages = "648--653",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Prognostic value of liver dysfunction assessed by MELD-XI scoring system in patients undergoing transcatheter aortic valve implantation

AU - OCEAN-TAVI investigators

AU - Arai, Takahide

AU - Yashima, Fumiaki

AU - Yanagisawa, Ryo

AU - Tanaka, Makoto

AU - Shimizu, Hideyuki

AU - Fukuda, Keiichi

AU - Watanabe, Yusuke

AU - Naganuma, Toru

AU - Araki, Motoharu

AU - Tada, Norio

AU - Yamanaka, Futoshi

AU - Shirai, Shinichi

AU - Yamamoto, Masanori

AU - Hayashida, Kentaro

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background There are limited data regarding the influence of liver dysfunction on outcomes of transcatheter aortic valve implantation (TAVI). Model for End-stage Liver Disease eXcluding International normalized ratio (MELD-XI) score, which was originally developed for patients with cirrhosis awaiting liver transplantation, has been reported as a predictor of heart disease. The aim of this study was to investigate the prognostic value of MELD-XI score for patients undergoing TAVI. Methods Data from the prospectively maintained Optimized transCathEter vAlvular iNtervention (OCEAN-TAVI) multicenter registry were collected in 749 patients who underwent TAVI between October 2013 and August 2015. MELD-XI score was calculated as follows: 11.76 × Ln (creatinine) + 5.11 × Ln (total bilirubin) + 9.44. Patients were categorized based on MELD-XI score > 10 or ≤ 10, and compared with regard to clinical characteristics and outcomes of TAVI. Results Higher MELD-XI score was associated with lower 30-day survival (95.6% vs 98.5%, P = 0.03). Kaplan–Meier analysis revealed that higher MELD-XI score also was associated with lower 6-month survival (P < 0.01). Multivariate Cox regression analysis showed that MELD-XI score was an independent predictor of 6-month cumulative mortality. Receiver operating characteristic analysis revealed that MELD-XI score showed better accuracy in predicting 6-month mortality compared with Logistic European System for Cardiac Operative Risk Evaluation, European System for Cardiac Operative Risk Evaluation II, and Society of Thoracic Surgeons scores (area under the curve = 0.67, 0.58, 0.57, and 0.60, respectively). Conclusion Evaluation of liver dysfunction according to MELD-XI score provides additional risk information for patients undergoing TAVI.

AB - Background There are limited data regarding the influence of liver dysfunction on outcomes of transcatheter aortic valve implantation (TAVI). Model for End-stage Liver Disease eXcluding International normalized ratio (MELD-XI) score, which was originally developed for patients with cirrhosis awaiting liver transplantation, has been reported as a predictor of heart disease. The aim of this study was to investigate the prognostic value of MELD-XI score for patients undergoing TAVI. Methods Data from the prospectively maintained Optimized transCathEter vAlvular iNtervention (OCEAN-TAVI) multicenter registry were collected in 749 patients who underwent TAVI between October 2013 and August 2015. MELD-XI score was calculated as follows: 11.76 × Ln (creatinine) + 5.11 × Ln (total bilirubin) + 9.44. Patients were categorized based on MELD-XI score > 10 or ≤ 10, and compared with regard to clinical characteristics and outcomes of TAVI. Results Higher MELD-XI score was associated with lower 30-day survival (95.6% vs 98.5%, P = 0.03). Kaplan–Meier analysis revealed that higher MELD-XI score also was associated with lower 6-month survival (P < 0.01). Multivariate Cox regression analysis showed that MELD-XI score was an independent predictor of 6-month cumulative mortality. Receiver operating characteristic analysis revealed that MELD-XI score showed better accuracy in predicting 6-month mortality compared with Logistic European System for Cardiac Operative Risk Evaluation, European System for Cardiac Operative Risk Evaluation II, and Society of Thoracic Surgeons scores (area under the curve = 0.67, 0.58, 0.57, and 0.60, respectively). Conclusion Evaluation of liver dysfunction according to MELD-XI score provides additional risk information for patients undergoing TAVI.

KW - Liver dysfunction

KW - MELD-XI score

KW - Severe symptomatic aortic stenosis

KW - Transcatheter aortic valve implantation

UR - http://www.scopus.com/inward/record.url?scp=84995961387&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995961387&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2016.11.096

DO - 10.1016/j.ijcard.2016.11.096

M3 - Article

C2 - 27883976

AN - SCOPUS:84995961387

VL - 228

SP - 648

EP - 653

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -