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Coronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model

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Coronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model. / Khan, Jaffar M; Kamioka, Norihiko; Lisko, John C; Perdoncin, Emily; Zhang, Cheng; Maini, Aneel; Chen, Mao; Li, Yijian; Ludwig, Sebastian; Westermann, Dirk; Amat Santos, Ignacio J; Kalińczuk, Łukasz; Sinning, Jan-Malte; Kawaguchi, Tomohiro; Fuku, Yasushi; Cheema, Asim N; Félix-Oliveira, Afonso; Yamamoto, Masanori; Kagase, Ai; Codner, Pablo; Valle, Raquel Del; Iyer, Vijay S; Kim, Hyo-Soo; Lin, Mao-Shin; Maini, Brijeshwar; Rodriguez, Roberto; Montorfano, Matteo; Ancona, Marco B; Tada, Norio; Miyasaka, Masaki; Ahmad, Hasan; Ruggiero, Nicholas J; Torguson, Rebecca; Ben-Dor, Itsik; Shults, Christian C; Weissman, Gaby; Lederman, Robert J; Greenbaum, Adam B; Babaliaros, Vasilis C; Waksman, Ron; Rogers, Toby.

In: JACC-CARDIOVASC INTE, Vol. 16, No. 4, 27.02.2023, p. 415-425.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Khan, JM, Kamioka, N, Lisko, JC, Perdoncin, E, Zhang, C, Maini, A, Chen, M, Li, Y, Ludwig, S, Westermann, D, Amat Santos, IJ, Kalińczuk, Ł, Sinning, J-M, Kawaguchi, T, Fuku, Y, Cheema, AN, Félix-Oliveira, A, Yamamoto, M, Kagase, A, Codner, P, Valle, RD, Iyer, VS, Kim, H-S, Lin, M-S, Maini, B, Rodriguez, R, Montorfano, M, Ancona, MB, Tada, N, Miyasaka, M, Ahmad, H, Ruggiero, NJ, Torguson, R, Ben-Dor, I, Shults, CC, Weissman, G, Lederman, RJ, Greenbaum, AB, Babaliaros, VC, Waksman, R & Rogers, T 2023, 'Coronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model', JACC-CARDIOVASC INTE, vol. 16, no. 4, pp. 415-425. https://doi.org/10.1016/j.jcin.2022.11.018

APA

Khan, J. M., Kamioka, N., Lisko, J. C., Perdoncin, E., Zhang, C., Maini, A., Chen, M., Li, Y., Ludwig, S., Westermann, D., Amat Santos, I. J., Kalińczuk, Ł., Sinning, J-M., Kawaguchi, T., Fuku, Y., Cheema, A. N., Félix-Oliveira, A., Yamamoto, M., Kagase, A., ... Rogers, T. (2023). Coronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model. JACC-CARDIOVASC INTE, 16(4), 415-425. https://doi.org/10.1016/j.jcin.2022.11.018

Vancouver

Khan JM, Kamioka N, Lisko JC, Perdoncin E, Zhang C, Maini A et al. Coronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model. JACC-CARDIOVASC INTE. 2023 Feb 27;16(4):415-425. https://doi.org/10.1016/j.jcin.2022.11.018

Bibtex

@article{156731cc822e434da4a580fb9047e0ba,
title = "Coronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model",
abstract = "BACKGROUND: Transcatheter aortic valve replacement (TAVR)-related coronary artery obstruction prediction remains unsatisfactory despite high mortality and novel preventive therapies.OBJECTIVES: This study sought to develop a predictive model for TAVR-related coronary obstruction in native aortic stenosis.METHODS: Preprocedure computed tomography and fluoroscopy images of patients in whom TAVR caused coronary artery obstruction were collected. Central laboratories made measurements, which were compared with unobstructed patients from a single-center database. A multivariate model was developed and validated against a 1:1 propensity-matched subselection of the unobstructed cohort.RESULTS: Sixty patients with angiographically confirmed coronary obstruction and 1,381 without obstruction were included. In-hospital death was higher in the obstruction cohort (26.7% vs 0.7%; P < 0.001). Annular area and perimeter, coronary height, sinus width, and sinotubular junction height and width were all significantly smaller in the obstructed cohort. Obstruction was most common on the left side (78.3%) and at the level of the coronary artery ostium (92.1%). Coronary artery height and sinus width, but not annulus area, were significant risk factors for obstruction by logistic regression but performed poorly in predicting obstruction. The new multivariate model (coronary obstruction IF cusp height > coronary height, AND virtual valve-to-coronary distance ≤4 mm OR culprit leaflet calcium volume >600 mm3) performed well, with an area under the curve of 0.93 (sensitivity = 0.93, specificity = 0.84) for the left coronary artery and 0.94 (sensitivity = 0.92, specificity = 0.96) for the right.CONCLUSIONS: A novel computed tomography-based multivariate prediction model that can be implemented routinely in real-world practice predicted coronary artery obstruction from TAVR in native aortic stenosis.",
keywords = "Humans, Transcatheter Aortic Valve Replacement, Hospital Mortality, Treatment Outcome, Aortic Valve Stenosis, Heart, Coronary Occlusion",
author = "Khan, {Jaffar M} and Norihiko Kamioka and Lisko, {John C} and Emily Perdoncin and Cheng Zhang and Aneel Maini and Mao Chen and Yijian Li and Sebastian Ludwig and Dirk Westermann and {Amat Santos}, {Ignacio J} and {\L}ukasz Kali{\'n}czuk and Jan-Malte Sinning and Tomohiro Kawaguchi and Yasushi Fuku and Cheema, {Asim N} and Afonso F{\'e}lix-Oliveira and Masanori Yamamoto and Ai Kagase and Pablo Codner and Valle, {Raquel Del} and Iyer, {Vijay S} and Hyo-Soo Kim and Mao-Shin Lin and Brijeshwar Maini and Roberto Rodriguez and Matteo Montorfano and Ancona, {Marco B} and Norio Tada and Masaki Miyasaka and Hasan Ahmad and Ruggiero, {Nicholas J} and Rebecca Torguson and Itsik Ben-Dor and Shults, {Christian C} and Gaby Weissman and Lederman, {Robert J} and Greenbaum, {Adam B} and Babaliaros, {Vasilis C} and Ron Waksman and Toby Rogers",
note = "Copyright {\textcopyright} 2023 American College of Cardiology Foundation. All rights reserved.",
year = "2023",
month = feb,
day = "27",
doi = "10.1016/j.jcin.2022.11.018",
language = "English",
volume = "16",
pages = "415--425",
journal = "JACC-CARDIOVASC INTE",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "4",

}

RIS

TY - JOUR

T1 - Coronary Obstruction From TAVR in Native Aortic Stenosis: Development and Validation of Multivariate Prediction Model

AU - Khan, Jaffar M

AU - Kamioka, Norihiko

AU - Lisko, John C

AU - Perdoncin, Emily

AU - Zhang, Cheng

AU - Maini, Aneel

AU - Chen, Mao

AU - Li, Yijian

AU - Ludwig, Sebastian

AU - Westermann, Dirk

AU - Amat Santos, Ignacio J

AU - Kalińczuk, Łukasz

AU - Sinning, Jan-Malte

AU - Kawaguchi, Tomohiro

AU - Fuku, Yasushi

AU - Cheema, Asim N

AU - Félix-Oliveira, Afonso

AU - Yamamoto, Masanori

AU - Kagase, Ai

AU - Codner, Pablo

AU - Valle, Raquel Del

AU - Iyer, Vijay S

AU - Kim, Hyo-Soo

AU - Lin, Mao-Shin

AU - Maini, Brijeshwar

AU - Rodriguez, Roberto

AU - Montorfano, Matteo

AU - Ancona, Marco B

AU - Tada, Norio

AU - Miyasaka, Masaki

AU - Ahmad, Hasan

AU - Ruggiero, Nicholas J

AU - Torguson, Rebecca

AU - Ben-Dor, Itsik

AU - Shults, Christian C

AU - Weissman, Gaby

AU - Lederman, Robert J

AU - Greenbaum, Adam B

AU - Babaliaros, Vasilis C

AU - Waksman, Ron

AU - Rogers, Toby

N1 - Copyright © 2023 American College of Cardiology Foundation. All rights reserved.

PY - 2023/2/27

Y1 - 2023/2/27

N2 - BACKGROUND: Transcatheter aortic valve replacement (TAVR)-related coronary artery obstruction prediction remains unsatisfactory despite high mortality and novel preventive therapies.OBJECTIVES: This study sought to develop a predictive model for TAVR-related coronary obstruction in native aortic stenosis.METHODS: Preprocedure computed tomography and fluoroscopy images of patients in whom TAVR caused coronary artery obstruction were collected. Central laboratories made measurements, which were compared with unobstructed patients from a single-center database. A multivariate model was developed and validated against a 1:1 propensity-matched subselection of the unobstructed cohort.RESULTS: Sixty patients with angiographically confirmed coronary obstruction and 1,381 without obstruction were included. In-hospital death was higher in the obstruction cohort (26.7% vs 0.7%; P < 0.001). Annular area and perimeter, coronary height, sinus width, and sinotubular junction height and width were all significantly smaller in the obstructed cohort. Obstruction was most common on the left side (78.3%) and at the level of the coronary artery ostium (92.1%). Coronary artery height and sinus width, but not annulus area, were significant risk factors for obstruction by logistic regression but performed poorly in predicting obstruction. The new multivariate model (coronary obstruction IF cusp height > coronary height, AND virtual valve-to-coronary distance ≤4 mm OR culprit leaflet calcium volume >600 mm3) performed well, with an area under the curve of 0.93 (sensitivity = 0.93, specificity = 0.84) for the left coronary artery and 0.94 (sensitivity = 0.92, specificity = 0.96) for the right.CONCLUSIONS: A novel computed tomography-based multivariate prediction model that can be implemented routinely in real-world practice predicted coronary artery obstruction from TAVR in native aortic stenosis.

AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR)-related coronary artery obstruction prediction remains unsatisfactory despite high mortality and novel preventive therapies.OBJECTIVES: This study sought to develop a predictive model for TAVR-related coronary obstruction in native aortic stenosis.METHODS: Preprocedure computed tomography and fluoroscopy images of patients in whom TAVR caused coronary artery obstruction were collected. Central laboratories made measurements, which were compared with unobstructed patients from a single-center database. A multivariate model was developed and validated against a 1:1 propensity-matched subselection of the unobstructed cohort.RESULTS: Sixty patients with angiographically confirmed coronary obstruction and 1,381 without obstruction were included. In-hospital death was higher in the obstruction cohort (26.7% vs 0.7%; P < 0.001). Annular area and perimeter, coronary height, sinus width, and sinotubular junction height and width were all significantly smaller in the obstructed cohort. Obstruction was most common on the left side (78.3%) and at the level of the coronary artery ostium (92.1%). Coronary artery height and sinus width, but not annulus area, were significant risk factors for obstruction by logistic regression but performed poorly in predicting obstruction. The new multivariate model (coronary obstruction IF cusp height > coronary height, AND virtual valve-to-coronary distance ≤4 mm OR culprit leaflet calcium volume >600 mm3) performed well, with an area under the curve of 0.93 (sensitivity = 0.93, specificity = 0.84) for the left coronary artery and 0.94 (sensitivity = 0.92, specificity = 0.96) for the right.CONCLUSIONS: A novel computed tomography-based multivariate prediction model that can be implemented routinely in real-world practice predicted coronary artery obstruction from TAVR in native aortic stenosis.

KW - Humans

KW - Transcatheter Aortic Valve Replacement

KW - Hospital Mortality

KW - Treatment Outcome

KW - Aortic Valve Stenosis

KW - Heart

KW - Coronary Occlusion

U2 - 10.1016/j.jcin.2022.11.018

DO - 10.1016/j.jcin.2022.11.018

M3 - SCORING: Journal article

C2 - 36858660

VL - 16

SP - 415

EP - 425

JO - JACC-CARDIOVASC INTE

JF - JACC-CARDIOVASC INTE

SN - 1936-8798

IS - 4

ER -