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Int J Cardiol. 2019 Dec 1;296:98-102. doi: 10.1016/j.ijcard.2019.08.033. Epub 2019 Aug 19.

Significance of the CAPRI risk score to predict heart failure hospitalization post-TAVI: The CAPRI-HF study.

Author information

1
Cardiology Department, Hôpital Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15 Lyon, France. Electronic address: brahim.harbaoui@chu-lyon.fr.
2
Cardiology Service, Rouen-Charles-Nicolle University Hospital Center, National Institute of Health and Medical Research U644, Rouen, France.
3
Service de Biostatistique et Bioinformatique, University of Lyon, CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69100 Villeurbanne, France.
4
Department of Cardiology, Gabriel Montpied University Hospital Center, Image Science for Interventional Techniques, Cardiovascular Interventional Therapy and Imaging, National Scientific Research Center UMR 6284, University of Auvergne, Clermont-Ferrand, France.
5
Cardiology Department, Hôpital Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France; University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15 Lyon, France.
6
University of Lyon, CREATIS UMR5220, INSERM U1044, INSA-15 Lyon, France; Radiology Department, Hôpital Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
7
Institut Cardiovasculaire Paris Sud, Ramsay - Générale de Santé, France.

Abstract

BACKGROUND:

Predictors of heart failure (HF) hospitalization after transcatheter aortic valve implantation (TAVI) are not well defined. CAPRI is a score for predicting 1-year post-TAVI cardiovascular and all-cause mortality. The aim of the present study is to assess the prognostic significance of the CAPRI score for HF hospitalization 1 year after TAVI.

METHODS AND RESULTS:

CAPRI-HF is an ancillary study of the C4CAPRI trial, analyzing 409 consecutive patients treated by TAVI. The primary outcome was hospitalization for HF during the first year post-intervention. The prognostic value of the CAPRI score was assessed by multivariable analysis adjusted for diabetes, atrial fibrillation, vascular route, pacemaker implantation, post-TAVI aortic regurgitation, transfusion and pulmonary artery systolic pressure. A subanalysis focused on patients with low-gradient aortic stenosis (LGAS). At 1 year, HF hospitalization occurred in 78 (19.9%) patients. Patients with HF were more prone to have diabetes, atrial fibrillation, renal dysfunction, lower mean aortic gradient, higher logistic EuroSCORE and higher CAPRI score (p < .05 for all associations). In the multivariable analysis, CAPRI score was the sole predictor of HF: hazard ratio (HR) for each 0.1 CAPRI score increase was 1.065, 95% confidence interval (CI) 1.021-1.110. This was confirmed when adjusted for EuroSCORE: HR 1.066, 95% CI 1.024-1.110. The predictive power of the CAPRI score increased for LGAS: HR 1.098, 95% CI 1.028-1.172.

CONCLUSIONS:

CAPRI score helps predict HF post-TAVI. Including the score in the decision-making process may help selecting candidates for TAVI and identifying patients who need close monitoring post-procedure.

KEYWORDS:

Aortic stiffness; Heart failure; Hospitalization; Outcome; Risk score; TAVR

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