The importance of the Heart Team evaluation ...
Type de document :
Compte-rendu et recension critique d'ouvrage
DOI :
PMID :
Titre :
The importance of the Heart Team evaluation before transcatheter aortic valve replacement: Results from the BRAVO‐3 trial
Auteur(s) :
Camaj, Anton [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Claessen, Bimmer [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Mehran, Roxana [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Yudi, Matias [Auteur]
Austin Health
Power, David [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Baber, Usman [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Hengstenberg, Christian [Auteur]
German Center for Cardiovascular Research [DZHK]
Technische Universität Munchen - Technical University Munich - Université Technique de Munich [TUM]
Lefèvre, Thierry [Auteur]
Hôpital Privé Jacques Cartier [Massy]
van Belle, Eric [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Giustino, Gennaro [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Guedeney, Paul [Auteur]
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN]
Institut de cardiologie [CHU Pitié-Salpêtrière]
Sorrentino, Sabato [Auteur]
Università degli Studi "Magna Graecia" di Catanzaro = University of Catanzaro [UMG]
Kupatt, Christian [Auteur]
Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München [LMU]
Webb, John [Auteur]
Hildick-Smith, David [Auteur]
Brighton and Sussex University Hospitals - NHS Trust [BSUH]
Hink, Hans [Auteur]
University Medical Center [Mainz]
Deliargyris, Efthymios [Auteur]
Anthopoulos, Prodromos [Auteur]
Sharma, Samin [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Kini, Annapoorna [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Sartori, Samantha [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Chandrasekhar, Jaya [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Dangas, George [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Claessen, Bimmer [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Mehran, Roxana [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Yudi, Matias [Auteur]
Austin Health
Power, David [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Baber, Usman [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Hengstenberg, Christian [Auteur]
German Center for Cardiovascular Research [DZHK]
Technische Universität Munchen - Technical University Munich - Université Technique de Munich [TUM]
Lefèvre, Thierry [Auteur]
Hôpital Privé Jacques Cartier [Massy]
van Belle, Eric [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Giustino, Gennaro [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Guedeney, Paul [Auteur]
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN]
Institut de cardiologie [CHU Pitié-Salpêtrière]
Sorrentino, Sabato [Auteur]
Università degli Studi "Magna Graecia" di Catanzaro = University of Catanzaro [UMG]
Kupatt, Christian [Auteur]
Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München [LMU]
Webb, John [Auteur]
Hildick-Smith, David [Auteur]
Brighton and Sussex University Hospitals - NHS Trust [BSUH]
Hink, Hans [Auteur]
University Medical Center [Mainz]
Deliargyris, Efthymios [Auteur]
Anthopoulos, Prodromos [Auteur]
Sharma, Samin [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Kini, Annapoorna [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Sartori, Samantha [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Chandrasekhar, Jaya [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Dangas, George [Auteur]
Icahn School of Medicine at Mount Sinai [New York] [MSSM]
Titre de la revue :
Catheterization and Cardiovascular Interventions
Éditeur :
Wiley
Date de publication :
2020-01-13
ISSN :
1522-1946
Mot(s)-clé(s) en anglais :
Heart Team
TAVR
logistic EuroSCORE
TAVR
logistic EuroSCORE
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Background/objectives: Clinicians use validated scores to risk-stratify patients undergoing transcatheter aortic valve replacement (TAVR). However, evaluation by the Heart Team often deems patients to be at higher risk ...
Lire la suite >Background/objectives: Clinicians use validated scores to risk-stratify patients undergoing transcatheter aortic valve replacement (TAVR). However, evaluation by the Heart Team often deems patients to be at higher risk than their formal scores suggest. We sought to assess clinical outcomes of TAVR patients defined as high-risk by the Heart Team's assessment versus the patient's logistic EuroSCORE (LES).Methods: The BRAVO-3 trial randomized patients at high risk (LES ≥ 18, or deemed inoperable by the Heart Team) to TAVR with periprocedural anticoagulation with unfractionated heparin versus bivalirudin. Endpoints included net adverse cardiac events (NACE: the composite of all-cause mortality, MI, stroke, or bleeding), major adverse cardiovascular events (MACE: death, MI, or stroke), the individual components of MACE, major vascular complications, BARC ≥ 3b bleeding and VARC life-threatening bleeding at 30 days. We compared patients deemed high-risk based on LES ≥ 18 versus high-risk by the Heart Team despite lower LES.Results: A total of 467/800 (58.4%) patients were deemed high-risk by the Heart Team despite LES < 18. After multivariable analysis, there were no differences in the odds of endpoints between groups (NACE, ORLES≥18 : 1.32, 95% CI 0.86-2.02, p = .21; MACE, ORLES≥18 : 1.27, 95% CI 0.72-2.25, p = .41; major vascular complications, ORLES≥18 : 0.97, 95% CI 0.65-1.44, p = .88; BARC ≥3b, ORLES≥18 : 1.38, 95% CI 0.82-2.33, p = .23; and VARC life-threatening bleeding, ORLES≥18 : 0.99, 95% CI 0.69-1.41, p = .95).Conclusion: Patients undergoing TAVR and labeled high-risk by LES ≥ 18 or Heart Team assessment despite LES < 18 have comparable short-term outcomes. Assignment of high-risk status to over 50% of patients is attributable to Heart Team's clinical assessment.Lire moins >
Lire la suite >Background/objectives: Clinicians use validated scores to risk-stratify patients undergoing transcatheter aortic valve replacement (TAVR). However, evaluation by the Heart Team often deems patients to be at higher risk than their formal scores suggest. We sought to assess clinical outcomes of TAVR patients defined as high-risk by the Heart Team's assessment versus the patient's logistic EuroSCORE (LES).Methods: The BRAVO-3 trial randomized patients at high risk (LES ≥ 18, or deemed inoperable by the Heart Team) to TAVR with periprocedural anticoagulation with unfractionated heparin versus bivalirudin. Endpoints included net adverse cardiac events (NACE: the composite of all-cause mortality, MI, stroke, or bleeding), major adverse cardiovascular events (MACE: death, MI, or stroke), the individual components of MACE, major vascular complications, BARC ≥ 3b bleeding and VARC life-threatening bleeding at 30 days. We compared patients deemed high-risk based on LES ≥ 18 versus high-risk by the Heart Team despite lower LES.Results: A total of 467/800 (58.4%) patients were deemed high-risk by the Heart Team despite LES < 18. After multivariable analysis, there were no differences in the odds of endpoints between groups (NACE, ORLES≥18 : 1.32, 95% CI 0.86-2.02, p = .21; MACE, ORLES≥18 : 1.27, 95% CI 0.72-2.25, p = .41; major vascular complications, ORLES≥18 : 0.97, 95% CI 0.65-1.44, p = .88; BARC ≥3b, ORLES≥18 : 1.38, 95% CI 0.82-2.33, p = .23; and VARC life-threatening bleeding, ORLES≥18 : 0.99, 95% CI 0.69-1.41, p = .95).Conclusion: Patients undergoing TAVR and labeled high-risk by LES ≥ 18 or Heart Team assessment despite LES < 18 have comparable short-term outcomes. Assignment of high-risk status to over 50% of patients is attributable to Heart Team's clinical assessment.Lire moins >
Langue :
Anglais
Vulgarisation :
Non
Source :
Fichiers
- 10.1002%20ccd.28717.pdf
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