title: Comparison of mid-term results of transcatheter aortic valve implantation in high-risk patients with logistic EuroSCORE ≥ 20% or < 20.
abstract: BACKGROUND
  Transcatheter aortic valve implantation (TAVI) is an established treatment method in selected high-risk patients with severe aortic stenosis. However, data on which patients gain most benefit from this procedure is still limited. According to the European consensus document, TAVI is recommended for high-risk patients with logistic EuroSCORE (log ES) ≥ 20%. To date, little is known about TAVI outcomes in patients with log ES < 20%.
  
  
  OBJECTIVE
  To evaluate outcomes of TAVI in high-risk patients with log ES ≥ 20% in comparison with high-risk patients with log ES < 20%.
  
  
  RESULTS
  Of 93 patients who underwent TAVI at our institution between January 2009 and December 2011, we identified 59 (63.4%) patients with log ES ≥ 20% (Group 1) and 34 (36.6%) patients with log ES < 20% (Group 2). The mean log ES was 30.9 ± 9.7% in Group 1 and 12.7 ± 4.9% in Group 2 (p < 0.01). Significant differences were found between the two groups in regard to age (82.9 ± 5.9 vs. 78.7 ± 7.8 years, p = 0.001), left ventricular ejection fraction (51.5 ± 14% vs. 60.4 ± 9.6%, p = 0.002), pulmonary artery systolic pressure (56 ± 11 vs. 49 ± 10.6 mm Hg, p = 0.02), and glomerular filtration rate (51.3 ± 18.4 vs. 60.6 ± 16.6 mL/min/m2, p = 0.02). Survival rates at 1 and 2 years were 76.6% and 69.0% in Group 1 and 89.0% and 83.6% in Group 2 (p = NS). However, cardiovascular mortality at 1 and 2 years was higher in Group 1 compared to Group 2 (21.4% and 28.6% vs. 8.1% and 10.8% in Groups 1 and 2, respectively).
  
  
  CONCLUSIONS
  The results of this study demonstrate that at 2 years of follow-up, TAVI in high-risk patients with log ES ≥ 20% was associated with a higher cardiovascular mortality compared to high-risk patients with log ES < 20%.
authors: Instytut Kardiologii 04-628 Warszawa Alpejska 42. zchmielak@ikard.pl.
authors: Zbigniew
authors: Z
authors: Chmielak
authors: Adam
authors: A
authors: Witkowski
authors: Maciej
authors: M
authors: Dąbrowski
authors: Marcin
authors: M
authors: Demkow
authors: Krzysztof
authors: K
authors: Kuśmierski
authors: Ewa
authors: E
authors: Sitkowska
authors: Jan
authors: J
authors: Jastrzębski
authors: Piotr
authors: P
authors: Szymański
authors: Tomasz
authors: T
authors: Hryniewiecki
authors: Katarzyna
authors: K
authors: Czerwińska
authors: Janina
authors: J
authors: Stępińska
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome
keywords: aortic valve stenosis; logistic EuroSCORE; transcatheter aortic valve implantation