Usefulness of a simple clinical risk prediction method, modified acef score, for transcatheter aortic valve implantation

Takahide Arai, Thierry Lefèvre, Kentaro Hayashida, Yusuke Watanabe, Stephen A. O’Connor, Thomas Hovasse, Mauro Romano, Philippe Garot, Erik Bouvier, Bernard Chevalier, Marie Claude Morice

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: We assessed the predictive accuracy of a simple risk score, modified age, creatinine clearance, ejection fraction (ACEFmodif) score, for outcome of transcatheter aortic valve implantation (TAVI). Methods and Results: We prospectively included 703 consecutive patients undergoing TAVI. Patients were divided into low, middle and high ACEFmodif tertiles. Increased ACEFmodif score was associated with a significantly higher 1-year mortality rate (22%, 28% and 36%, P<0.01) and higher risk of acute kidney injury (AKI; 10%, 10% and 22%, P<0.01). On multivariate logistic regression analysis, ACEFmodif score was the only independent predictor of AKI. On multivariate Cox regression, ACEFmodif score was an independent predictor of 1-year cumulative mortality. Although the area under curve (AUC) showed that all risk scores poorly predicted the incidence of AKI and 1-year cumulative mortality, ACEFmodif score was more efficient in predicting the incidence of AKI compared with STS, LES and ES II (AUC, 0.61, 0.55, 0.54, 0.57, respectively). Furthermore, ACEFmodif score had similar accuracy in predicting 1-year mortality compared with other risk scores (AUC, 0.61, 0.61, 0.61, 0.61, respectively). Conclusions: ACEFmodif score may provide useful information for predicting AKI, 30-day and 1-year mortality in patients undergoing TAVI, but these results need further confirmation.

Original languageEnglish
Pages (from-to)1496-1503
Number of pages8
JournalCirculation Journal
Volume79
Issue number7
DOIs
Publication statusPublished - 2015 Jun 9

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Mortality
Area Under Curve
Incidence
Acute Kidney Injury
Creatinine
Logistic Models
Regression Analysis
Transcatheter Aortic Valve Replacement

Keywords

  • Acute kidney injury
  • Creatinine clearance
  • Ejection fraction score
  • Modified age
  • Severe symptomatic aortic stenosis
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Arai, T., Lefèvre, T., Hayashida, K., Watanabe, Y., O’Connor, S. A., Hovasse, T., ... Morice, M. C. (2015). Usefulness of a simple clinical risk prediction method, modified acef score, for transcatheter aortic valve implantation. Circulation Journal, 79(7), 1496-1503. https://doi.org/10.1253/circj.CJ-14-1242

Usefulness of a simple clinical risk prediction method, modified acef score, for transcatheter aortic valve implantation. / Arai, Takahide; Lefèvre, Thierry; Hayashida, Kentaro; Watanabe, Yusuke; O’Connor, Stephen A.; Hovasse, Thomas; Romano, Mauro; Garot, Philippe; Bouvier, Erik; Chevalier, Bernard; Morice, Marie Claude.

In: Circulation Journal, Vol. 79, No. 7, 09.06.2015, p. 1496-1503.

Research output: Contribution to journalArticle

Arai, T, Lefèvre, T, Hayashida, K, Watanabe, Y, O’Connor, SA, Hovasse, T, Romano, M, Garot, P, Bouvier, E, Chevalier, B & Morice, MC 2015, 'Usefulness of a simple clinical risk prediction method, modified acef score, for transcatheter aortic valve implantation', Circulation Journal, vol. 79, no. 7, pp. 1496-1503. https://doi.org/10.1253/circj.CJ-14-1242
Arai, Takahide ; Lefèvre, Thierry ; Hayashida, Kentaro ; Watanabe, Yusuke ; O’Connor, Stephen A. ; Hovasse, Thomas ; Romano, Mauro ; Garot, Philippe ; Bouvier, Erik ; Chevalier, Bernard ; Morice, Marie Claude. / Usefulness of a simple clinical risk prediction method, modified acef score, for transcatheter aortic valve implantation. In: Circulation Journal. 2015 ; Vol. 79, No. 7. pp. 1496-1503.
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AU - Lefèvre, Thierry

AU - Hayashida, Kentaro

AU - Watanabe, Yusuke

AU - O’Connor, Stephen A.

AU - Hovasse, Thomas

AU - Romano, Mauro

AU - Garot, Philippe

AU - Bouvier, Erik

AU - Chevalier, Bernard

AU - Morice, Marie Claude

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AB - Background: We assessed the predictive accuracy of a simple risk score, modified age, creatinine clearance, ejection fraction (ACEFmodif) score, for outcome of transcatheter aortic valve implantation (TAVI). Methods and Results: We prospectively included 703 consecutive patients undergoing TAVI. Patients were divided into low, middle and high ACEFmodif tertiles. Increased ACEFmodif score was associated with a significantly higher 1-year mortality rate (22%, 28% and 36%, P<0.01) and higher risk of acute kidney injury (AKI; 10%, 10% and 22%, P<0.01). On multivariate logistic regression analysis, ACEFmodif score was the only independent predictor of AKI. On multivariate Cox regression, ACEFmodif score was an independent predictor of 1-year cumulative mortality. Although the area under curve (AUC) showed that all risk scores poorly predicted the incidence of AKI and 1-year cumulative mortality, ACEFmodif score was more efficient in predicting the incidence of AKI compared with STS, LES and ES II (AUC, 0.61, 0.55, 0.54, 0.57, respectively). Furthermore, ACEFmodif score had similar accuracy in predicting 1-year mortality compared with other risk scores (AUC, 0.61, 0.61, 0.61, 0.61, respectively). Conclusions: ACEFmodif score may provide useful information for predicting AKI, 30-day and 1-year mortality in patients undergoing TAVI, but these results need further confirmation.

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