Higher pre-procedural Karnofsky index independently predicted in-hospital procedural success after transcatheter aortic valve implantation (OR 1.04; 95% CI 1.00-1.08; P=0.032).
Cohort (n=168)
Yes
What are the predictors of in-hospital procedural success in patients with symptomatic aortic valve stenosis undergoing TAVI?
Pre-procedural functional performance status (Karnofsky index) is an independent predictor of in-hospital procedural success after TAVI, suggesting patients with better functional status may derive greater benefit.
Odds Ratio: 1.04 (95% CI 1–1.08)
p-value: p=0.032
AIMS: The purpose of the present analysis was to identify predictors of procedural success of percutaneous transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We prospectively assessed in-hospital outcome of patients undergoing TAVI at two institutions. We analysed clinical, morphological, and procedural parameters using univariate and multivariate regression models. Between 2005 and 2008, a total of 168 consecutive patients with symptomatic aortic valve stenosis underwent TAVI using the self-expanding CoreValve Revalving prosthesis. Patients (93%) were highly symptomatic with a New York Heart Association grade III/IV and a mean aortic valve area of 0.66 +/- 0.21 cm(2). Acute and in-hospital procedural success rates were 90.5 and 83.9%, respectively, with an in-hospital mortality, myocardial infarction, and stroke rate of 11.9, 1.8, and 3.6%, respectively. Predictors of in-hospital procedural success were type of access (OR 0.33, 95% CI 0.13-0.82, P = 0.017), prior coronary intervention (OR 5.3, 95% CI 1.20-23.41, P = 0.028) and pre-procedural Karnofsky index using univariate regression. Pre-procedural Karnofsky index emerged as the only independent predictor (OR 1.04, 95% CI 1.00-1.08, P = 0.032) in the multivariate analysis. CONCLUSION: Pre-procedural functional performance status predicts the in-hospital outcome after TAVI. Patients with a good functional status are likely to benefit more from TAVI than previously reported high-risk patients.
Buellesfeld et al. (2009) conducted a cohort in Symptomatic aortic valve stenosis (n=168). Pre-procedural Karnofsky index was evaluated on In-hospital procedural success (OR 1.04, 95% CI 1.00-1.08, p=0.032). Higher pre-procedural Karnofsky index independently predicted in-hospital procedural success after transcatheter aortic valve implantation (OR 1.04; 95% CI 1.00-1.08; P=0.032).