Hioki Hirofumi, Watanabe Yusuke, Kozuma Ken, Kawashima Hideyuki, Nagura Fukuko, Nakashima Makoto, Kataoka Akihisa, Yamamoto Masanori, Naganuma Toru, Araki Motoharu, Tada Norio, Shirai Shinichi, Yamanaka Futoshi, Higashimori Akihiro, Mizutani Kazuki, Tabata Minoru, Takagi Kensuke, Ueno Hiroshi, Hayashida Kentaro
Division of Cardiology, Department of Internal Medicine, Teikyo University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan.
Toyohashi Heart Center, Aichi, Japan.
Heart Vessels. 2019 Dec;34(12):1976-1983. doi: 10.1007/s00380-019-01443-9. Epub 2019 May 29.
This study is aimed to evaluate the performance of MAGGIC risk score for predicting mortality by external validation using multicenter transcatheter aortic valve replacement (TAVR) registry. We assessed 1383 patients who underwent TAVR from October 2013 to April 2016. Patients were divided into 2 groups according to the median of MAGGIC score and we compared the incidence of all-cause death between high and low MAGGIC score. To assess whether the MAGGIC risk score add prognostic value on STS risk score, we also compared the incidence of all-cause death between the 2 groups according to low, intermediate, and high STS score. The median of MAGGIC score was 29 (interquartile range: 13-46). Within 2 years, 147 cases of all-cause death were observed. The high MAGGIC (30-46) risk score was significantly associated with an increased risk of all-cause death as compared to low MAGGIC (11-29) risk score and this relationship was also observed in patients with high STS risk score. However, this relationship was not observed in patients with low and intermediate STS score. Multivariate analysis showed that the MAGGIC risk score was an independent predictor of all-cause death (hazard ratio, 1.07; 95% confidence interval, 1.03-1.11). Our results demonstrated that the MAGGIC score predicts all-cause death in TAVR population and provides better risk stratification, particularly in patients with high STS risk.
本研究旨在通过多中心经导管主动脉瓣置换术（TAVR）登记处的外部验证，评估MAGGIC风险评分预测死亡率的性能。我们评估了2013年10月至2016年4月期间接受TAVR的1383例患者。根据MAGGIC评分的中位数将患者分为两组，我们比较了高MAGGIC评分组和低MAGGIC评分组全因死亡的发生率。为了评估MAGGIC风险评分是否能增加对STS风险评分的预后价值，我们还根据低、中、高STS评分比较了两组之间全因死亡的发生率。MAGGIC评分的中位数为29（四分位间距：13 - 46）。在2年内，观察到147例全因死亡病例。与低MAGGIC（11 - 29）风险评分相比，高MAGGIC（30 - 46）风险评分与全因死亡风险增加显著相关，并且在高STS风险评分的患者中也观察到这种关系。然而，在低和中STS评分的患者中未观察到这种关系。多变量分析显示，MAGGIC风险评分是全因死亡的独立预测因素（风险比，1.07；95%置信区间，1.03 - 1.11）。我们的结果表明，MAGGIC评分可预测TAVR人群中的全因死亡，并提供更好的风险分层，特别是在高STS风险的患者中。
