Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement

Hirofumi Hioki, Yusuke Watanabe, Ken Kozuma, Masanori Yamamoto, Toru Naganuma, Motoharu Araki, Norio Tada, Shinichi Shirai, Futoshi Yamanaka, Akihiro Higashimori, Kazuki Mizutani, Minoru Tabata, Kensuke Takagi, Hiroshi Ueno, Kentaro Hayashida

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The prognostic impact of skeletal muscle mass, assessed using lean body mass (LBM), remain unclear in patients who underwent transcatheter aortic valve replacement (TAVR). The aim of this study to assess prognostic impact of LBM on mortality after TAVR. Methods: We assessed 1,613 patients (median age 85 years, 70% female) who underwent TAVI from October 2013 to April 2016 using OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry data. LBM was calculated using the James formula. The primary endpoint was all-cause death after TAVR. Results: Median follow-up period was 287 days (interquartile range 110-462). The Kaplan-Meier analysis demonstrated that patients with low LBM had significantly higher incidence of all-cause death than those with high LBM in male (32.3% vs. 9.9%, log rank P<0.001) and female (15.8% vs. 9.2%, log-rank P=0.011). On contrary, the risk stratification using body mass index (BMI) could not validate into female patients who underwent TAVR. The multivariate analysis showed that the LBM was an independent predictor of all-cause death in male (Hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.89-0.98) and female (HR 0.94; 95% CI 0.89-0.99). Inversely, the assessment using BMI could not identify the high-risk population in a female. Conclusions: The patients with low LBM had the higher incidence of all-cause death after TAVR than those with high LBM, regardless of gender. Thus, the risk stratification using LBM might provide further insight to identify the high-risk TAVR population, compared to conventional risk stratification using BMI.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusAccepted/In press - 2018 Jan 1

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Cause of Death
Body Mass Index
Confidence Intervals
Incidence
Kaplan-Meier Estimate
Population
Registries
Transcatheter Aortic Valve Replacement
Skeletal Muscle
Multivariate Analysis
Mortality

Keywords

  • Prognosis
  • Transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement. / Hioki, Hirofumi; Watanabe, Yusuke; Kozuma, Ken; Yamamoto, Masanori; Naganuma, Toru; Araki, Motoharu; Tada, Norio; Shirai, Shinichi; Yamanaka, Futoshi; Higashimori, Akihiro; Mizutani, Kazuki; Tabata, Minoru; Takagi, Kensuke; Ueno, Hiroshi; Hayashida, Kentaro.

In: Catheterization and Cardiovascular Interventions, 01.01.2018.

Research output: Contribution to journalArticle

Hioki, H, Watanabe, Y, Kozuma, K, Yamamoto, M, Naganuma, T, Araki, M, Tada, N, Shirai, S, Yamanaka, F, Higashimori, A, Mizutani, K, Tabata, M, Takagi, K, Ueno, H & Hayashida, K 2018, 'Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement', Catheterization and Cardiovascular Interventions. https://doi.org/10.1002/ccd.27547
Hioki, Hirofumi ; Watanabe, Yusuke ; Kozuma, Ken ; Yamamoto, Masanori ; Naganuma, Toru ; Araki, Motoharu ; Tada, Norio ; Shirai, Shinichi ; Yamanaka, Futoshi ; Higashimori, Akihiro ; Mizutani, Kazuki ; Tabata, Minoru ; Takagi, Kensuke ; Ueno, Hiroshi ; Hayashida, Kentaro. / Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement. In: Catheterization and Cardiovascular Interventions. 2018.
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abstract = "Background: The prognostic impact of skeletal muscle mass, assessed using lean body mass (LBM), remain unclear in patients who underwent transcatheter aortic valve replacement (TAVR). The aim of this study to assess prognostic impact of LBM on mortality after TAVR. Methods: We assessed 1,613 patients (median age 85 years, 70{\%} female) who underwent TAVI from October 2013 to April 2016 using OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry data. LBM was calculated using the James formula. The primary endpoint was all-cause death after TAVR. Results: Median follow-up period was 287 days (interquartile range 110-462). The Kaplan-Meier analysis demonstrated that patients with low LBM had significantly higher incidence of all-cause death than those with high LBM in male (32.3{\%} vs. 9.9{\%}, log rank P<0.001) and female (15.8{\%} vs. 9.2{\%}, log-rank P=0.011). On contrary, the risk stratification using body mass index (BMI) could not validate into female patients who underwent TAVR. The multivariate analysis showed that the LBM was an independent predictor of all-cause death in male (Hazard ratio [HR] 0.93; 95{\%} confidence interval [CI] 0.89-0.98) and female (HR 0.94; 95{\%} CI 0.89-0.99). Inversely, the assessment using BMI could not identify the high-risk population in a female. Conclusions: The patients with low LBM had the higher incidence of all-cause death after TAVR than those with high LBM, regardless of gender. Thus, the risk stratification using LBM might provide further insight to identify the high-risk TAVR population, compared to conventional risk stratification using BMI.",
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T1 - Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement

AU - Hioki, Hirofumi

AU - Watanabe, Yusuke

AU - Kozuma, Ken

AU - Yamamoto, Masanori

AU - Naganuma, Toru

AU - Araki, Motoharu

AU - Tada, Norio

AU - Shirai, Shinichi

AU - Yamanaka, Futoshi

AU - Higashimori, Akihiro

AU - Mizutani, Kazuki

AU - Tabata, Minoru

AU - Takagi, Kensuke

AU - Ueno, Hiroshi

AU - Hayashida, Kentaro

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The prognostic impact of skeletal muscle mass, assessed using lean body mass (LBM), remain unclear in patients who underwent transcatheter aortic valve replacement (TAVR). The aim of this study to assess prognostic impact of LBM on mortality after TAVR. Methods: We assessed 1,613 patients (median age 85 years, 70% female) who underwent TAVI from October 2013 to April 2016 using OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry data. LBM was calculated using the James formula. The primary endpoint was all-cause death after TAVR. Results: Median follow-up period was 287 days (interquartile range 110-462). The Kaplan-Meier analysis demonstrated that patients with low LBM had significantly higher incidence of all-cause death than those with high LBM in male (32.3% vs. 9.9%, log rank P<0.001) and female (15.8% vs. 9.2%, log-rank P=0.011). On contrary, the risk stratification using body mass index (BMI) could not validate into female patients who underwent TAVR. The multivariate analysis showed that the LBM was an independent predictor of all-cause death in male (Hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.89-0.98) and female (HR 0.94; 95% CI 0.89-0.99). Inversely, the assessment using BMI could not identify the high-risk population in a female. Conclusions: The patients with low LBM had the higher incidence of all-cause death after TAVR than those with high LBM, regardless of gender. Thus, the risk stratification using LBM might provide further insight to identify the high-risk TAVR population, compared to conventional risk stratification using BMI.

AB - Background: The prognostic impact of skeletal muscle mass, assessed using lean body mass (LBM), remain unclear in patients who underwent transcatheter aortic valve replacement (TAVR). The aim of this study to assess prognostic impact of LBM on mortality after TAVR. Methods: We assessed 1,613 patients (median age 85 years, 70% female) who underwent TAVI from October 2013 to April 2016 using OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry data. LBM was calculated using the James formula. The primary endpoint was all-cause death after TAVR. Results: Median follow-up period was 287 days (interquartile range 110-462). The Kaplan-Meier analysis demonstrated that patients with low LBM had significantly higher incidence of all-cause death than those with high LBM in male (32.3% vs. 9.9%, log rank P<0.001) and female (15.8% vs. 9.2%, log-rank P=0.011). On contrary, the risk stratification using body mass index (BMI) could not validate into female patients who underwent TAVR. The multivariate analysis showed that the LBM was an independent predictor of all-cause death in male (Hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.89-0.98) and female (HR 0.94; 95% CI 0.89-0.99). Inversely, the assessment using BMI could not identify the high-risk population in a female. Conclusions: The patients with low LBM had the higher incidence of all-cause death after TAVR than those with high LBM, regardless of gender. Thus, the risk stratification using LBM might provide further insight to identify the high-risk TAVR population, compared to conventional risk stratification using BMI.

KW - Prognosis

KW - Transcatheter aortic valve replacement

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