Evaluation of aortic arch calcification to predict prognosis after transcatheter aortic valve replacement

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Severe aortic stenosis (n=464). Intervention: Moderate or severe aortic arch calcification vs. No or mild aortic arch calcification. Primary outcome: 3-year all-cause mortality (HR 1.78, 95% CI 1.04-3.06, p=0.037).

Dao Zhou; Hanyi Dai; Wenjing Sheng; Rongrong Zheng; Jiaqi Fan; Abuduwufuer Yidilisi; Ailifeire Aihemaiti; Qiong Liu; Yuxin He; Yuchao Guo; Qifeng Zhu; Shuangshuang Yang; Yanxia Wei; Jianan Wang; Xianbao Liu

doi:10.1038/s41598-024-83536-8

February 21, 2025Scientific ReportsOpen Access

Evaluation of aortic arch calcification to predict prognosis after transcatheter aortic valve replacement

View Full Paper

Ask AI

Bookmark

Share

Key result

Moderate or severe aortic arch calcification independently predicted higher 3-year all-cause mortality (HR 1.78) compared to no or mild calcification after transcatheter aortic valve replacement.

Figures

Why the study?

Aortic arch calcification is rarely reported routinely due to the lack of an easy evaluation method, and its association with clinical prognosis after TAVR remains unclear.

Does moderate or severe aortic arch calcification predict 3-year mortality in patients with severe aortic stenosis undergoing TAVR?

Study Design

Type

Cohort (n=464)

Blinding

Blinded image analysis

Multicenter

No

Structured PICO

Does moderate or severe aortic arch calcification predict 3-year mortality in patients with severe aortic stenosis undergoing TAVR?

P

Population

464 consecutive patients with severe aortic stenosis undergoing transcatheter aortic valve replacement, followed for a median of 25.1 months to assess the prognostic impact of aortic arch calcification.

E

Exposure

Presence of moderate or severe aortic arch calcification (AAC) evaluated by pre-operative contrast-enhanced multidetector computed tomography (MDCT).

C

Comparator

No or mild aortic arch calcification (AAC).

O

Outcome

3-year all-cause mortality.hard clinical

Main Result

Hazard Ratio: 1.78 (95% CI 1.04–3.06)

Absolute Event Rate: 27.7% vs 12.3%

p-value: p=0.037

Moderate to severe aortic arch calcification, evaluated by a rapid semi-quantitative MDCT method, is an independent predictor of 3-year all-cause mortality in patients undergoing TAVR.

Limitations

Method cannot identify low-density atherosclerosis
Method is only focused on assessing aortic arch calcification
Potential patient selection biases due to exclusion of patients without analyzable MDCT images
Observer variability exists when analyzing images with boundary values
Baseline characteristics (age, STS score, renal function) differed between groups
Relatively small sample size and limited follow-up duration

Implication

May refine post-TAVR risk stratification; leaves open whether calcification should guide interventions.

Abstract

Few centers routinely report aortic arch calcification (AAC) due to the lack of an easy and effective evaluation method. The association between AAC and the clinical prognosis of patients who undergo transcatheter aortic valve replacement (TAVR) is unclear. We aimed to develop a rapid method to evaluate AAC in patients who underwent TAVR and to further assess their prognosis. We enrolled 464 consecutive patients with aortic stenosis who underwent TAVR. Patients with severe (11.2%), moderate (18.5%), mild (58.2%), and no (12.1%) AAC had an estimated 3-year all-cause mortality incidence of 39.6%, 20.8%, 13.4%, and 6.7% (log rank p < 0.001), respectively. Patients with severe AAC had a significantly higher incidence of both cardiovascular (log rank p = 0.002) and non-cardiovascular mortality (log rank p = 0.009), whereas patients with moderate AAC had a higher incidence of only non-cardiovascular mortality (p = 0.003) compared with patients with no/mild AAC. Moderate/severe AAC was an independent predictor of 3-year all-cause mortality in univariate (hazard ratio [HR]: 2.39, 95% confidence interval [CI]: 1.41-4.03; p = 0.001) and multivariate COX regression analyses (HR: 1.78, 95%CI: 1.04-3.06; p = 0.037). Our rapid semi-quantitative method to evaluate AAC is highly reproducible and can be used to assess AAC in patients who undergo TAVR.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Zhou et al. (2025) conducted a cohort in Severe aortic stenosis (n=464). Moderate or severe aortic arch calcification vs. No or mild aortic arch calcification was evaluated on 3-year all-cause mortality (HR 1.78, 95% CI 1.04-3.06, p=0.037). Moderate or severe aortic arch calcification independently predicted higher 3-year all-cause mortality (HR 1.78) compared to no or mild calcification after transcatheter aortic valve replacement.

synapsesocial.com/papers/6a99aea41969380488b2593d https://doi.org/10.1038/s41598-024-83536-8

View Full Paper

Ask AI

Bookmark

Share

Evaluation of aortic arch calcification to predict prognosis after transcatheter aortic valve replacement

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Evaluation of aortic arch calcification to predict prognosis after transcatheter aortic valve replacement

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading