Abstract
Background: Interracial differences in the distribution and prognostic value of conventional Society of Thoracic Surgeons (STS) score on long-term mortality after transcatheter aortic valve replacement (TAVR) are uncertain. Objectives: This study aims to compare the impact of STS scores on clinical outcomes at 1-year after TAVR between Asian and non-Asian populations. Methods: We used the Trans-Pacific TAVR (TP-TAVR) registry, a multinational multicenter, observational registry involving patients undergoing TAVR at 2 major centers in the United States and 1 major center in Korea. Patients were classified into 3 groups (low, intermediate, and high-risk) according to the STS score and compared between STS risk groups and race. The primary outcome was all-cause mortality at 1-year. Results: Among 1,412 patients, 581 were Asian and 831 were non-Asian. The distribution of the STS risk score group was different between Asian and non-Asian groups (62.5% low-, 29.8% intermediate-, and 7.7% high-risk in Asian vs 40.6% low-, 39.1% intermediate-, and 20.3% high-risk in non-Asian). In the Asian population, the all-cause mortality at 1-year was substantially higher in the high-risk STS group than in the low- and intermediate-risk groups (3.6% low-risk, 8.7% intermediate-risk, and 24.4% high-risk; log-rank P < 0.001), which was primarily driven by noncardiac mortality. In the non-Asian group, there was a proportional increase in all-cause mortality at 1-year according to the STS risk category (5.3% low-risk, 12.6% intermediate-risk, and 17.8% high-risk; log-rank P < 0.001).
Original language | English (US) |
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Pages (from-to) | 376-387 |
Number of pages | 12 |
Journal | JACC: Asia |
Volume | 3 |
Issue number | 3 |
DOIs | |
State | Published - Jun 2023 |
Funding
The TP-TAVR registry contains data from a multinational, multicenter, observational cohort study that included all consecutive patients with symptomatic severe AS who underwent TAVR at 2 major academic medical centers in the United States (Stanford University School of Medicine, Stanford, California, and the Feinberg School of Medicine at Northwestern University, Chicago, Illinois) and 1 in South Korea (Asan Medical Center, Seoul) ( NCT03826264 ). 20 , 21 Beginning in February 2019, data were retrospectively collected for cases performed before initiation and prospectively thereafter. Each center’s institutional review board or ethics committee approved the registry protocol. The TP-TAVR registry was partly funded by the CardioVascular Research Foundation (Seoul, Korea) and a supporting grant (2020IF0016) from the Asan Institute for Life Sciences and Corporate Relations of Asan Medical Center, Seoul, South Korea.
Keywords
- Society of Thoracic Surgeons score
- aortic valve stenosis
- mortality
- transcatheter aortic valve replacement
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine