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82 Does the CHA2S2VASC or R2-CHA2DS2VASC Predict Procedural and Short-term Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation
  1. Tahir Hamid1,
  2. Tawfiq Choudhury1,
  3. Simon Anderson1,
  4. Izhar Hashmi2,
  5. David Roberts2,
  6. Richard Levy1
  1. 1University Hospital of South Manchester
  2. 2Blackpool Teaching Hospitals NHS Trust

Abstract

Introduction Transcatheter aortic valve implantation (TAVI) is associated with peri and post-procedural morbidity and mortality. Currently there is a lack of an established scoring system to further stratify patients who are potential TAVI candidates. We used the CHA2DS2-Vasc score and a modified R2CHADS-VASC score that we devised, (R2- for pre-existing Renal impairment, and pre-existing Rhythm abnormality (RBBB/LBBB) on ECG to determine if they predict mortality and morbidity in patients undergoing TAVI.

Methods The data source is a retrospective analysis of prospective data registry of consecutive patients who underwent TAVI at two tertiary centres between April 2008 and April 2013.

Results A total of 236 patients with severe aortic stenosis underwent TAVI. 215 patients received the CoreValve(®) (Medtronic Inc., Minneapolis, USA) prosthesis while 21 had Edwards-SAPIEN (Edward Lifesciences, Irvine, California) prosthesis.Mean age was 80 ± 8 years. Patients demographics included: 44% (103) female, 25% (59) diabetic, 67%(157) hypertensive, 44% (66), 60% (136) smokers and 27% (42) had chronic renal failure. 18 (12%) had previous transient ischaemic attacks or cerebrovascular accident. The 28-day mortality was 19.2% in those patients with a CHA2DS2-Vasc score of ≥6 whereas only 5.6% in those with a score <6 (p < 0.05). Using the R2-CHA2DS2-Vasc score, the difference was more pronounced with a 28-day mortality of 25% in those patients with a R2- CHA2DS2-Vasc score of ≥7 compared to 5.8% in those with a R2- CHA2DS2-Vasc of <7 (p < 0.05). The 1yr mortality rates, however, were not statistically significantly associated with the CHA2DS2-Vasc or R2- CHA2DS2-Vasc scores.

Conclusion Our study demonstrates the potential use of the CHA2DS2-Vasc Score and the modified R2-CHA2DS2-Vasc scores to risk stratify patients undergoing the TAVI procedure.

  • Transcatheter aortic valve implantation
  • CHA2DS2-Vasc score
  • R2-CHA2DS2-Vasc

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