Usefulness of the CHA 2 DS 2 -VASc Score to Predict Outcome in Patients Who Underwent Transcatheter Aortic Valve Implantation

Katia Orvin, Amos Levi, Uri Landes, Tamir Bental, Alexander Sagie, Yaron Shapira, Hana Vaknin-Assa, Abid Assali, Ran Kornowski

Research output: Contribution to journalArticlepeer-review

Abstract

Risk assessment for transcatheter aortic valve implantation (TAVI) patients remains challenging, especially in elderly and high-risk candidates. Although several risk factors contribute to increased morbidity and mortality after TAVI, simple risk scores for routine use are lacking. Applying the CHA 2 DS 2 -VAS C (congestive heart failure, hypertension, age ≥ 75 years, diabetes, prior stroke, vascular disease, age 65–74 years, sex [female] category) score as a novel risk stratification tool for conditions other than atrial fibrillation and stroke prevention has been previously examined; however, its usefulness in a population of patients with aortic stenosis after TAVI has not been established. Thus, we investigated 633 consecutive patients who underwent TAVI between November 2008 and May 2017, and calculated the CHA 2 DS 2 -VAS C score. Patients were stratified according to their CHA 2 DS 2 -VAS C score into 3 categories (0 to 3, 4 to 6, 7 to 9), and the association between CHA 2 DS 2 -VAS C score and 1-year clinical outcomes (stroke, all-cause mortality, and combined outcome of stroke or mortality) was evaluated. We found that both stroke and mortality at 1 year were significantly more frequent with increasing CHA 2 DS 2 -VAS C score (p = 0.012 and p = 0.025, respectively). Each single-point rise in CHA 2 DS 2 -VAS C score was associated with a 38% increase in the 1-year combined outcome of mortality or stroke (p = 0.022; C index 0.615). In conclusion, CHA 2 DS 2 -VAS C score can be used as a simple and effective tool to predict 1-year clinical outcomes including death and stroke in patients who underwent TAVI.

Original languageEnglish
Pages (from-to)241-248
Number of pages8
JournalAmerican Journal of Cardiology
Volume121
Issue number2
DOIs
StatePublished - 15 Jan 2018

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