Key result
High baseline KCCQ-OS is linked to ~5-fold greater odds of good health 3 years post-TAVR.
Why the study?
Aortic stenosis impairs health-related quality of life, but the prognostic impact of patient-reported health status prior to TAVR is not fully established.
Does baseline patient-reported health status predict being alive with good health status at 3 years after transfemoral TAVR in patients with symptomatic severe AS?
RCT (n=692)
randomized
Yes
Does baseline patient-reported health status predict being alive with good health status at 3 years after transfemoral TAVR in patients with symptomatic severe AS?
Baseline patient-reported health status is a strong predictor of long-term patient-centered outcomes, including survival with good quality of life, at 3 years post-TAVR.
Baseline KCCQ-OS may refine post-TAVR prognosis discussions; extends observational data but leaves open any role in decision-making.
BACKGROUND: Aortic stenosis (AS) impairs health-related quality of life but the prognostic impact of patient-reported health status prior to transcatheter aortic valve replacement (TAVR) is not fully established. OBJECTIVES: To investigate the association of patient-reported health status at baseline with clinical outcomes and health status after transfemoral TAVR in patients with symptomatic severe AS. METHODS: In the investigator-initiated, multicenter SCOPE I randomized trial, patients underwent TAVR who provided baseline Kansas City Cardiomyopathy Questionnaire (KCCQ) assessment were included in this post-hoc analysis. An integrated patient-centered outcome was defined as being alive with good health status (KCCQ overall summary score [KCCQ-OS] ≥75 without a decline of >10 points from baseline). RESULTS: Of 739 patients enrolled in SCOPE I, 692 were included in the present analysis. Median baseline KCCQ-OS was 54.9 [39.6-71.9] distributed as follows: KCCQ-OS <25 - 74 (10.7%), 25-49 - 222 (32.1%), 50-74 - 271 (39.2%), ≥75 - 125 (18.1%). At 3 years after TAVR, higher baseline KCCQ-OS was associated with a greater likelihood of being alive with good health status (KCCQ-OS 50-75 vs. 0-25: adjusted odds ratio 2.25, 95% CI 1.12-4.54; 75-100 vs. 0-25: adjusted odds ratio 5.15, 95% CI 2.33-11.3). Restricted cubic spline modelling demonstrated an approximately linear relationship between baseline KCCQ-OS and all-cause mortality, and alive with good health status. CONCLUSIONS: In this post-hoc analysis of SCOPE I, better baseline patient-reported health status was associated with a higher probability of being alive with good health status up to 3 years after TAVR. CLINICAL TRIAL REGISTRATION: https://www. CLINICALTRIALS: gov. NCT03011346.
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Tomii et al. (2026) conducted an RCT in symptomatic severe aortic stenosis (n=692). Higher baseline KCCQ-OS (75-100) vs. Baseline KCCQ-OS 0-25 was evaluated on Alive with good health status (KCCQ-OS ≥75 without a decline of >10 points from baseline) (adjusted OR 5.15, 95% CI 2.33-11.3). Higher baseline patient-reported health status (KCCQ-OS 75-100 vs 0-25) was associated with a greater likelihood of being alive with good health status 3 years after TAVR (OR 5.15; 95% CI 2.33-11.3).
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