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- Dokumenttyp:
- Article; Journal Article
- Autor(en):
- Hausleiter, Jörg; Lachmann, Mark; Stolz, Lukas; Bedogni, Francesco; Rubbio, Antonio P; Estévez-Loureiro, Rodrigo; Raposeiras-Roubin, Sergio; Boekstegers, Peter; Karam, Nicole; Rudolph, Volker
- Titel:
- Artificial intelligence-derived risk score for mortality in secondary mitral regurgitation treated by transcatheter edge-to-edge repair: the EuroSMR risk score.
- Abstract:
- BACKGROUND AND AIMS: Risk stratification for mitral valve transcatheter edge-to-edge repair (M-TEER) is paramount in the decision-making process to appropriately select patients with severe secondary mitral regurgitation (SMR). This study sought to develop and validate an artificial intelligence-derived risk score (EuroSMR score) to predict 1-year outcomes (survival or survival + clinical improvement) in patients with SMR undergoing M-TEER. METHODS: An artificial intelligence-derived risk score was developed from the EuroSMR cohort (4172 and 428 patients treated with M-TEER in the derivation and validation cohorts, respectively). The EuroSMR score was validated and compared with established risk models. RESULTS: The EuroSMR risk score, which is based on 18 clinical, echocardiographic, laboratory, and medication parameters, allowed for an improved discrimination of surviving and non-surviving patients (hazard ratio 4.3, 95% confidence interval 3.7-5.0; P < .001), and outperformed established risk scores in the validation cohort. Prediction for 1-year mortality (area under the curve: 0.789, 95% confidence interval 0.737-0.842) ranged from <5% to >70%, including the identification of an extreme-risk population (2.6% of the entire cohort), which had a very high probability for not surviving beyond 1 year (hazard ratio 6.5, 95% confidence interval 3.0-14; P < .001). The top 5% of patients with the highest EuroSMR risk scores showed event rates of 72.7% for mortality and 83.2% for mortality or lack of clinical improvement at 1-year follow-up. CONCLUSIONS: The EuroSMR risk score may allow for improved prognostication in heart failure patients with severe SMR, who are considered for a M-TEER procedure. The score is expected to facilitate the shared decision-making process with heart team members and patients.
- Zeitschriftentitel:
- Eur Heart J
- Jahr:
- 2024
- Band / Volume:
- 45
- Heft / Issue:
- 11
- Seitenangaben Beitrag:
- 922-936
- Volltext / DOI:
- doi:10.1093/eurheartj/ehad871
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/38243773
- Print-ISSN:
- 0195-668X
- TUM Einrichtung:
- Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)
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