Background: Transcatheter aortic valve replacement (TAVR) is a popular method of treating severe symptomatic aortic valve stenosis in patients who cannot benefit from surgical aortic valve replacement (SAVR).
Objective: We aimed to evaluate how well the modified R2CHA2DS2-VASc score (M-R2CHA2DS2-VASc) predicts short-term mortality (≤ 30 days) in TAVR patients.
Methods: This observational multi-center study included 70 patients aged > 55 years with symptomatic severe aortic valve stenosis who were assigned to undergo transfemoral TAVR. The R2CHA2DS2-VASc score was estimated for all patients, which comprises persistent kidney disorder and the existence of RBBB or LBBB along with traditional CHA2DS2-VASc score variables. All patients underwent TAVR using transfemoral access, and the decision to choose a valve was made by the heart team. Follow-up was conducted for short-term mortality, defined as all-cause mortality within 30 days after TAVR.
Results: The studied patients had a mean age of 76 ± 4 years, with 58.6% males. The median R2CHA2DS2-VASc score was 4 ranging from 1–9. ROC analysis revealed that the R2CHA2DS2-VASc score had an AUC of 0.911, with a 95% CI of 0.831 - 0.990 (P < 0.001) for predicting the composite endpoint. The best cut-off point for the R2CHA2DS2-VASc score was > 4, with 82.40% sensitivity and 84.90% specificity. In multivariable logistic regression analysis, the R2CHA2DS2-VASc score was a significant predictor of death.
Conclusion: In patients undergoing TAVR, the M-R2CHA2DS2-VASc score is a valuable tool for predicting short-term mortality.