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Frailty in Older Adults Undergoing Aortic Valve Replacement

Wednesday, August 2, 2017

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Source Name: Journal of the American College of Cardiology


Jonathan Afilalo, Sandra Lauck, Dae H. Kim, Thierry Lefèvre, Nicolo Piazza, Kevin Lachapelle, Giuseppe Martucci, Andre Lamy, Marino Labinaz, Mark D. Peterson, Rakesh C. Arora, Nicolas Noiseux, Andrew Rassi, Igor F. Palacios, Philippe Généreux, Brian R. Lindman, Anita W. Asgar, Caroline A. Kim, Amanda Trnkus, José A. Morais, Yves Langlois, Lawrence G. Rudski, Jean-Francois Morin, Jeffrey J. Popma, John G. Webb, Louis P. Perrault

Frailty is an important factor in patients undergoing either Transcatheter or Surgical Aortic Valve Replacement. However, it is hard to assess. Multiple scoring systems have been proposed which are either underperforming or are cumbersome to calculate.

In the current study, the authors introduced and tested the Essential Frailty Toolset (EFT), consisting of four items: lower-extremity weakness, cognitive impairment, anemia, and hypoalbumenia. The EFT outperformed other frailty assesment tools in approximatly 1000 elderly patients undergoing either TAVR or SAVR.

Dr. Mack notes in the accompanying editorial that several conclusions can be drawn:

1. Frailty can be assessd using an easy tool

2. Frailty is predictive of 1-year mortality after either TAVR or SAVR

3. EFT improves the power of the STS-PROM to predict 1 year mortality

4. EFT is also predictive for 30-day mortality and 1-year mortality and disability

This important study shows that frailty can classified easily. This facilitates comparitive studies, heart team discussions and clinical decision-making in patients undertoing an invasive treatment for aortic stenosis.

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