{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:54:39Z","timestamp":1765828479770,"version":"3.48.0"},"reference-count":29,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002799","name":"Capital Medical University","doi-asserted-by":"publisher","award":["PYZ22168"],"award-info":[{"award-number":["PYZ22168"]}],"id":[{"id":"10.13039\/501100002799","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Capital Medical University Affiliated Beijing Shijitan Hospital Youth Foundation","award":["2023-q06"],"award-info":[{"award-number":["2023-q06"]}]},{"name":"the National Key Research and Development Project, the Ministry of Science and Technology of the People\u2019s Republic of China","award":["2020YFC2004800"],"award-info":[{"award-number":["2020YFC2004800"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,9]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate the impact of the Charlson Comorbidity Index (CCI) on in-hospital outcomes in patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR) and to compare the efficacy of transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with different comorbidity burdens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The National Clinical Research Center for Cardiovascular Diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 3380 AS patients who underwent AVR in Beijing Anzhen Hospital from January 2015 to October 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Patients were stratified into low (0\u20131) and high (\u22652) CCI groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was Valve Academic Research Consortium-2 (VARC-2) composite early safety endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with high CCI scores exhibited significantly higher rates of VARC-2 composite adverse outcomes compared with those with low scores (50.3% vs 44.2%, p=0.001). After adjusting for confounding factors, high CCI scores were independently associated with the VARC-2 composite adverse outcomes (OR=1.36, 95% CI 1.17 to 1.58, p&lt;0.001). In patients aged \u226565 years, TAVR demonstrated lower composite event rates compared with SAVR, regardless of CCI score (low CCI: 17.6% vs 54.3%, p&lt;0.001; high CCI: 33.7% vs 62.8%, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CCI is a significant predictor of in-hospital composite adverse events in AS patients undergoing AVR. TAVR may be preferred over SAVR for patients aged \u226565 years, irrespective of comorbidity burden, to minimise composite events risk. These findings underscore the importance of considering comorbidity burden in treatment decision-making for AS patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05797402\">NCT05797402<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-083677","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:20:17Z","timestamp":1750141217000},"page":"e083677","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association between Charlson Comorbidity Index and in-hospital outcomes among aortic stenosis patients undergoing aortic valve replacement: an observational study at the National Clinical Research Center for Cardiovascular Diseases"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct05797402","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05797402","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1248-9996","authenticated-orcid":false,"given":"Xin","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4030-0799","authenticated-orcid":false,"given":"Wen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 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