Universität zu Köln

Schaefer, Matthieu, Koerber, Maria I., Vimalathasan, Rakave, Mauri, Victor, Iliadis, Christos ORCID: 0000-0001-7655-8500, Metze, Clemens, ten Freyhaus, Henrik, Baldus, Stephan, Polidori, M. Cristina and Pfister, Roman (2021). Risk Stratification of Patients Undergoing Percutaneous Repair of Mitral and Tricuspid Valves Using a Multidimensional Geriatric Assessment. Circ.-Cardiovasc. Qual. Outcomes, 14 (8). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1941-7713

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Abstract

Background: Given their advanced age and high comorbidity, individual risk assessment is crucial in patients undergoing transcatheter mitral and tricuspid valve repair. Therefore, we evaluated the use of a comprehensive geriatric assessment score, the multidimensional prognostic index (MPI), for risk stratification in these patients. Methods: We conducted a prospective, observational single-center study, including 226 patients undergoing percutaneous repair for mitral or tricuspid regurgitation. The MPI was calculated preprocedural and covers 8 domains (activities of daily living, instrumental activities of daily living, mental status, nutrition, risk of pressure ulcers, comorbidity, medication, and marital/cohabitation status). We sought to identify an association of MPI score with procedural outcomes and 6-month mortality. Results: A total of 53.1% of patients were stratified as low risk according to MPI (MPI-1 group), 44.2% as medium risk (MPI-2 group), and 2.7% as high risk (MPI-3 group). Procedural efficacy and safety were similar between groups. The estimated survival rate at 6 months was 97 +/- 2% in MPI-1 group, 79 +/- 4% in MPI-2 group (hazard ratio, 6.90 [95% CI, 2.36-12.2]; P <= 0.001) and 50 +/- 20% in MPI-3 group (hazard ratio, 20.3 [95% CI, 4.51-91.3]; P<0.001). An increase in 1 SD of the MPI score (0.14 points, possible range of MPI score 0-1) was associated with a hazard ratio of 2.13 (95% CI, 1.58-2.73; P <= 0.001) for death after 6 months. The risk association of the MPI with mortality remained significant in multivariate analysis including risk factors, such as peripheral artery disease and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels. Conclusions: A comprehensive geriatric assessment with the MPI score provides additional information on mortality risk beyond established cardiovascular risk factors.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schaefer, Matthieu UNSPECIFIED UNSPECIFIED UNSPECIFIED Koerber, Maria I. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vimalathasan, Rakave UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED orcid.org/0000-0001-7655-8500 UNSPECIFIED Metze, Clemens UNSPECIFIED UNSPECIFIED UNSPECIFIED ten Freyhaus, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Polidori, M. Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-566716
DOI:	10.1161/CIRCOUTCOMES.120.007624
Journal or Publication Title:	Circ.-Cardiovasc. Qual. Outcomes
Volume:	14
Number:	8
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1941-7713
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ONE-YEAR OUTCOMES; PROGNOSTIC INDEX; FRAILTY; MORTALITY; SYSTEM; MULTICENTER; QUESTIONNAIRE; ANNULOPLASTY; REPLACEMENT; VALIDATION Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56671