Takahide Arai1, Fumiaki Yashima2, Ryo Yanagisawa2, Makoto Tanaka2, Hideyuki Shimizu3, Keiichi Fukuda2, Yusuke Watanabe4, Toru Naganuma5, Motoharu Araki6, Norio Tada7, Futoshi Yamanaka8, Shinichi Shirai9, Masanori Yamamoto10, Kentaro Hayashida2. 1. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. Electronic address: tarai@a3.keio.jp. 2. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. 3. Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan. 4. Division of Cardiology, Department of Internal Medicine, Teikyo University Hospital, Tokyo, Japan. 5. Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan. 6. Department of Cardiovascular Medicine, Yokohama City Eastern Hospital, Kanagawa, Japan. 7. Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan. 8. Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan. 9. Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan. 10. Division of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan.
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.
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.
Authors: Robert B Hawkins; Bree Ann C Young; J Hunter Mehaffey; Alan M Speir; Mohammed A Quader; Jeffrey B Rich; Gorav Ailawadi Journal: Ann Thorac Surg Date: 2019-01-09 Impact factor: 4.330
Authors: Muhammad Z Khan; Muhammad U Khan; Muhammad Bilal Munir; Safi U Khan; Mohammed Osman; Sudarshan Balla Journal: Catheter Cardiovasc Interv Date: 2020-03-04 Impact factor: 2.692