BMC Cardiovascular Disorders (Jan 2018)

Comprehensive geriatric assessment in patients undergoing transcatheter aortic valve implantation – results from the CGA-TAVI multicentre registry

  • Andrea Ungar,
  • Giulio Mannarino,
  • Nathalie van der Velde,
  • Jan Baan,
  • Marie-Pierre Thibodeau,
  • Jean-Bernard Masson,
  • Gennaro Santoro,
  • Martijn van Mourik,
  • Sofie Jansen,
  • Cornelia Deutsch,
  • Peter Bramlage,
  • Jana Kurucova,
  • Martin Thoenes,
  • Stefania Maggi,
  • Andreas W. Schoenenberger

DOI
https://doi.org/10.1186/s12872-017-0740-x
Journal volume & issue
Vol. 18, no. 1
pp. 1 – 16

Abstract

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Abstract Background In older patients with aortic stenosis (AS) undergoing TAVI, the potential role of prior CGA is not well established. To explore the value of comprehensive geriatric assessment (CGA) for predicting mortality and/or hospitalisation within the first 3 months after transcatheter aortic valve implantation (TAVI). Methods An international, multi-centre, prospective registry (CGA-TAVI) was established to gather data on CGA results and medium-term outcomes in geriatric patients undergoing TAVI. Logistic regression was used to evaluate the predictive value of a multidimensional prognostic index (MPI); a short physical performance battery (SPPB); and the Silver Code, which was based on administrative data, for predicting death and/or hospitalisation in the first 3 months after TAVI (primary endpoint). Results A total of 71 TAVI patients (mean age 85.4 years; mean log EuroSCORE I 22.5%) were enrolled. Device success according to VARC criteria was 100%. After adjustment for selected baseline characteristics, a higher (poorer) MPI score (OR: 3.34; 95% CI: 1.39–8.02; p = 0.0068) and a lower (poorer) SPPB score (OR: 1.15; 95% CI: 1.01–1.54; p = 0.0380) were found to be associated with an increased likelihood of the primary endpoint. The Silver Code did not show any predictive ability in this population. Conclusions Several aspects of the CGA have shown promise for being of use to physicians when predicting TAVI outcomes. While the MPI may be useful in clinical practice, the SPPB may be of particular value, being simple and quick to perform. Validation of these findings in a larger sample is warranted. Trial registration The trial was registered in ClinicalTrials.gov on November 7, 2013 ( NCT01991444 ).

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