Prognostic Value of the Frailty Index in Patients with Severe Aortic Regurgitation Undergoing Transcatheter Aortic Valve Replacement.
- 1Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.
- 2Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Abstract
Background
Frailty represents a multidimensional vulnerability that predicts poor outcomes in cardiovascular disease. Its prognostic value in patients with severe native aortic regurgitation (AR) undergoing transcatheter aortic valve replacement (TAVR) is not well defined.Objective
To determine whether an abbreviated cumulative deficit frailty index predicts one-year all-cause mortality and to explore its interaction with N-terminal pro-B-type natriuretic peptide in this population.Methods
In this post hoc analysis of the prospective China DVD2 multicenter cohort, 298 patients with isolated severe AR who underwent TAVR were included. Frailty was assessed preprocedurally using an abbreviated 8-9-item cumulative deficit frailty index (FI) encompassing functional, cognitive, nutritional, and clinical domains. The primary endpoint was one-year all-cause mortality. The cohort-derived FI threshold for mortality was derived using time-dependent receiver operating characteristic analysis. Cox proportional hazards models adjusted for age, sex, body mass index, atrial fibrillation, and NT-proBNP were applied. Subgroup and interaction analyses were performed.Results
The cohort-derived FI threshold was 0.407, classifying 32 patients as high frailty. High-FI patients exhibited greater symptom burden, higher prevalence of atrial fibrillation, larger left atrial diameter, and elevated NT-proBNP. One-year mortality was significantly higher in the high-FI group compared with low-FI patients (15.6% vs 3.4%, P = 0.010). High FI was associated with higher one-year mortality in Model 3 (HR 4.00, 95% CI 1.18-13.50; P = 0.026). No significant multiplicative or additive interaction with NT-proBNP was observed.Conclusions
Among patients undergoing TAVR for severe native aortic regurgitation, a high FI was associated with higher one-year mortality. These findings extend prior evidence on the prognostic implications of frailty to this understudied population.
Related
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- Risk of Short-Term Stroke in Non-High-Risk Patients Undergoing Transcatheter Aortic Valve Replacement vs Surgical Aortic Valve Replacement: A Systematic Review and Meta-Analysis
- Coexisting Moderate-to-Severe Tricuspid Regurgitation and Renal Dysfunction Identify a High-Risk Group After Transcatheter Aortic Valve Replacement
BibTeX
@article{yu2026prognostic,
title = {{Prognostic Value of the Frailty Index in Patients with Severe Aortic Regurgitation Undergoing Transcatheter Aortic Valve Replacement.}},
author = {Qingyun Yu and Qingan Fu and Zaihua Cheng and Jie Feng and Xiao Huang and Ren Gong and Haiyan Xu and Yongjian Wu and Yanqing Wu},
journal = {Clinical interventions in aging},
year = {2026},
month = oct,
doi = {10.2147/cia.s643768},
url = {https://europepmc.org/article/MED/42974471},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Prognostic Value of the Frailty Index in Patients with Severe Aortic Regurgitation Undergoing Transcatheter Aortic Valve Replacement.
AU - Qingyun Yu
AU - Qingan Fu
AU - Zaihua Cheng
AU - Jie Feng
AU - Xiao Huang
AU - Ren Gong
AU - Haiyan Xu
AU - Yongjian Wu
AU - Yanqing Wu
PY - 2026
DA - 2026/10/29
JO - Clinical interventions in aging
DO - 10.2147/cia.s643768
UR - https://europepmc.org/article/MED/42974471
AB - Background Frailty represents a multidimensional vulnerability that predicts poor outcomes in cardiovascular disease. Its prognostic value in patients with severe native aortic regurgitation (AR) undergoing transcatheter aortic valve replacement (TAVR) is not well defined.Objective To determine whether an abbreviated cumulative deficit frailty index predicts one-year all-cause mortality and to explore its interaction with N-terminal pro-B-type natriuretic peptide in this population.Methods In this post hoc analysis of the prospective China DVD2 multicenter cohort, 298 patients with isolated severe AR who underwent TAVR were included. Frailty was assessed preprocedurally using an abbreviated 8-9-item cumulative deficit frailty index (FI) encompassing functional, cognitive, nutritional, and clinical domains. The primary endpoint was one-year all-cause mortality. The cohort-derived FI threshold for mortality was derived using time-dependent receiver operating characteristic analysis. Cox proportional hazards models adjusted for age, sex, body mass index, atrial fibrillation, and NT-proBNP were applied. Subgroup and interaction analyses were performed.Results The cohort-derived FI threshold was 0.407, classifying 32 patients as high frailty. High-FI patients exhibited greater symptom burden, higher prevalence of atrial fibrillation, larger left atrial diameter, and elevated NT-proBNP. One-year mortality was significantly higher in the high-FI group compared with low-FI patients (15.6% vs 3.4%, P = 0.010). High FI was associated with higher one-year mortality in Model 3 (HR 4.00, 95% CI 1.18-13.50; P = 0.026). No significant multiplicative or additive interaction with NT-proBNP was observed.Conclusions Among patients undergoing TAVR for severe native aortic regurgitation, a high FI was associated with higher one-year mortality. These findings extend prior evidence on the prognostic implications of frailty to this understudied population.
SN - 1176-9092
SN - 1178-1998
ER -