TY - JOUR JO - EuroIntervention TI - Systematic review and meta-analysis of current risk models in predicting short-term mortality after transcatheter aortic valve replacement AB - <p><strong>Aims:</strong> The aim of this study was to evaluate the performance of risk stratification models (RSMs) in predicting short-term mortality after transcatheter aortic valve replacement (TAVR).</p> <p><strong>Methods and results:</strong> MEDLINE and Scopus were queried to identify studies which validated RSMs designed to assess 30-day or in-hospital mortality after TAVR. Discrimination and calibration were assessed using C-statistics and observed/expected ratios (OERs), respectively. C-statistics were pooled using a random-effects inverse-variance method, while OERs were pooled using the Peto odds ratio. A good RSM is defined as one with a C-statistic &gt;0.7 and an OER close to 1.0. Twenty-four studies (n=68,215 patients) testing 11 different RSMs were identified. Discrimination of all RSMs was poor (C-statistic &lt;0.7); however, certain TAVR-specific RSMs such as the in-hospital STS/ACC TVT (C-statistic=0.65) and STT (C-statistic=0.66) predicted individual mortality more reliably than surgical models (C-statistic range=0.59-0.61). A good calibration was demonstrated by the in-hospital STS/ACC TVT (OER=0.99), 30-day STS/ACC TVT (OER=1.08) and STS (OER=1.01) models. Baseline dialysis (OER: 2.64 [1.88, 3.70]; p&lt;0.001) was the strongest predictor of mortality.</p> <p><strong>Conclusions:</strong> This study demonstrates that the STS/ACC TVT model (in-hospital and 30-day) and the STS model have accurate calibration, making them useful for comparison of centre-level risk-adjusted mortality. In contrast, the discriminative ability of currently available models is limited.</p> AU - Siddiqi Jamal Tariq AU - Usman Shariq Muhammad AU - Khan Shahzeb Muhammad AU - Khan Arbaz Arshad Muhammad AU - Riaz Haris AU - Khan U. Safi AU - Murad Hassan M. AU - Kavinsky J. Clifford AU - Doukky Rami AU - Kalra Ankur AU - Desai Y. Milind AU - Bhatt L. Deepak VL - 15 IS - 17 Y1 - 17/04/2020 Y1 - 2020 DOI - 10.4244/EIJ-D-19-00636 SP - 1497 EP - 1505 KW - aortic stenosis KW - death KW - tavi PB - Europa Digital & Publishing SE - Interventions for valvular disease and heart failure UR - https://eurointervention.pcronline.com/article/performance-of-current-risk-models-in-predicting-short-term-mortality-after-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis SN - 1774-024X ER -