ArticleStructural heart : the journal of the Heart Team2020
Can Clinical Predictive Models Identify Patients Who Should Not Receive TAVR? A Systematic Review.
Article in Structural heart : the journal of the Heart Team, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Advancing the Contemporary Multidisciplinary Heart Valve Team: Update on Priorities for Clinicians and Programs.Structural heart : the journal of the Heart Team · 2025Review
- Evolving perspectives on aortic stenosis: the increasing importance of evaluating the right ventricle before aortic valve intervention.Frontiers in cardiovascular medicine · 2024Review
- Identifying Predictors of Psychological Problems Among Adolescents With Congenital Heart Disease for Referral to Psychological Care: A Pilot Study.CJC pediatric and congenital heart disease · 2023Article
- Left ventricular stroke volume index following transcatheter aortic valve replacement is an early predictor of 1-year survival.Clinical cardiology · 2023Article
- The Prognosis of Baseline Mitral Regurgitation in Patients with Transcatheter Aortic Valve Implantation.Journal of clinical medicine · 2021Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundOne third of high- and prohibitive-risk TAVR patients remain severely symptomatic or die 1 year after treatment. There is interest in identifying individuals for whom this procedure is futile and should not be offered.
methodsWe performed a systematic review of the highest reported stratum of risk in TAVR clinical predictive models (CPMs). We explore whether currently available predictive models can identify patients for whom TAVR is futile, based on a quantitative futility definition and the observed and predicted outcomes for patients in the highest stratum of risk.
results17 TAVR CPMs representing 69,191 treated patients were published from 2013 to 2018. When reported, the median number of patients in the highest stratum of risk was 569 (range 1 to 1759). Observed mortality for this risk stratum ranged from 9% at 30 days to 59% at 1 year after TAVR. Statistical confidence in these observed event rates was low. The highest predicted event rates ranged from 11.0% for in-hospital mortality to 75.1% for the composite of mortality or high symptom burden 1 year after TAVR.
conclusionNo high-risk TAVR group in currently available TAVR CPMs had an appropriate event rate and adequate statistical power to meet a quantitative definition of futility.
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