Publication date: 2016

This study aimed to determine if age-adjusted Charlson comorbidity index could predict mortality in patients undergoing transcatheter mitral valve repair (TMVR), and to assess its discriminatory performance in long-term outcomes. Comorbidity increases markedly with aging, and they often negatively impact its prognosis. Although mortality with TMVR is significantly less than for open mitral valve surgery in this population, it remains a concern to identify which patients will benefit from this treatment. Some prognostic metrics have been reported to guide better patient selection, however, universal risk stratification measures in this population, have not been established. Methods We retrospectively reviewed 222 patients undergoing TMVR. Cox proportional hazard models were applied to select the demographic characteristics that were associated with cumulative mortality. Receiver operating-characteristic analyses were performed for predicting all-cause mortality, and discriminatory performance was assessed. Results We found age-adjusted Charlson comorbidity index (hazard ratio 1.33, 95% confidence interval 1.16–1.51, p <0.001), New York Heart Association classification, atrial fibrillation were independently associated with mortality. The age-adjusted Charlson comorbidity index demonstrated excellent discriminative performance for predicting mortality at 3 and 5 years (area under the curve 0.81 and 0.83, respectively). They were greater than those of STS score and greatest in any other single parameters at 1, 3, and 5 years in ROC analysis. Kaplan-Meier curve demonstrated age-adjusted Charlson comorbidity index ≥8 had poor prognosis following TMVR.

Тип: Article

10.DOI 1016/j.jacc.2016.09.774