Prognostic Value of Baseline Sarcopenia on 1-year Mortality in Patients Undergoing Transcatheter Aortic Valve Implantation
- There is limited data regarding the association between sarcopenia and clinical outcomes in patients who underwent transcatheter aortic valve implantation (TAVI). From the prospective ASAN-TAVI registry, we evaluated a total of 522 patients with severe aortic stenosis who underwent TAVI between March 2010 and November 2018. Routine pre-TAVI computed tomography scan was used to calculate the skeletal muscle index (SMI), which was defined as skeletal muscle area at the L3 level divided by height squared; subject patients were classified into the gender-specific tertile groups of SMI. The patients' mean age was 79 years and 49% were men. Mean SMI values were 41.3 +/- 6.7 cm(2)/m(2) in men and 34.1 +/- 6.5 cm(2)/m(2) in women. The Kaplan-Meier estimates of all-cause mortality at 12 months were higher in the low-tertile group than in the mid- and high-tertile groups (15.5%, 7.1%, and 6.2%, respectively; p = 0.036). In multivariate analysis, low-tertile of SMI was an independent predictor of mortality (vs high-tertile of SMI, hazard ratio 2.69; 95% confidence interval, 1.18 to 6.12; p = 0.019). The all-cause mortality was substantially higher in the groups with high-surgical risk plus low SMI tertile. The risk assessment with addition of SMI on conventional STS-PROM score was significantly improved by statistical measures of model reclassification and discrimination. In patients who underwent TAVI, sarcopenia measured by SMI was significantly associated with an increased risk of 1-year mortality. The prognostic impact of SMI-measured sarcopenia was more prominent in patients with high surgical risks. (C) 2020 Elsevier Inc. All rights reserved.
- 강도윤; 고유선; 고의홍; 김경원; 김대희; 김준범; 김호진; 박덕우; 박승정; 박한빛; 안정민; 윤용훈; 이승아; 조상철; 주석중
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- Aged; 80 and over; Aortic Valve / surgery*; Aortic Valve Stenosis / complications; Aortic Valve Stenosis / mortality; Aortic Valve Stenosis / surgery*; Female; Follow-Up Studies; Humans; Male; Skeletal / diagnostic imaging*; Prognosis; Prospective Studies; Registries*; Republic of Korea / epidemiology; Risk Factors; Sarcopenia / complications*; Sarcopenia / diagnosis; Severity of Illness Index; Survival Rate / trends; X-Ray Computed; Transcatheter Aortic Valve Replacement / methods*
- AMERICAN JOURNAL OF CARDIOLOGY
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