CAC scores help predict TAVR mortality

Coronary artery calcium (CAC) scoring can provide value as an independent predictor of 30-day or one-year mortality following transcatheter aortic valve replacement (TAVR), according to new findings published in Radiology.

The study’s authors tracked data from 309 patients with severe aortic stenosis who underwent CT imaging during the planning process for TAVR. All data came from a nationwide TAVR registry, and patients were treated from May 2008 to September 2019.

There were 14 deaths—all from cardiovascular causes—after 30 days. There were 34 deaths—82% from cardiovascular causes—after one year.

Among patients included in this analysis, the median CAC score was 334. CAC scores higher than 1,000 were an accurate predictor of 30-day and one-year TAVR mortality.

In addition, the team noted, adding the CAC score helped make the commonly used European System for Cardiac Operative Risk Evaluation score more accurate.

“A potential drawback of CAC scoring in patients who have undergone TAVR is the need for a separate nonenhanced CT scan,” wrote first author Matthias Eberhard, MD, a radiologist at University Hospital Zurich in Switzerland, and colleagues. “However, adding non-contrast CT of the heart to CT angiography of the chest and abdomen may not have a relevant impact regarding the potential excess risk from ionizing radiation on cancer induction in this usually older population (mean age of 81 years in our study).”

Even with additional imaging exam, the team concluded that CAC scores could be used “for clinical decision-making in candidates for TAVR to guide the selection of medical, interventional or surgical approaches.”

Read the full analysis in Radiology here.

 

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Michael Walter
Michael Walter, Managing Editor

Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.

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