{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:55:37Z","timestamp":1755795337461,"version":"3.44.0"},"reference-count":42,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2020,2,3]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A logistic European System for Cardiac Operative Risk Evaluation (logEuroSCORE) \u226520% is frequently recognised as a finite criteria for transcatheter aortic valve implantation (TAVI) reimbursement, despite guideline modifications to reflect the appropriacy of TAVI in selected lower-risk patients. The aim was to evaluate the clinical value of this threshold cut-off in TAVI patients and to identify factors associated with mortality in those below this threshold.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analysed data from a single-centre, German, observational, TAVI-patient registry, gathered between 2008 and 2016. Patients were stratified by logEuroSCORE (\u2265 or &lt;20%) for comparisons. Logistic regression was performed to identify predictors of mortality at 1\u2009year, with this analysis used to generate a calculated (\u2018real\u2019) risk value for each patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>1679 patients (logEuroSCORE &lt;20%: n=789; logEuroSCORE \u226520%: n=890) were included. LogEuroSCORE &lt;20% patients were significantly younger (80.1 vs 81.6 years; p&lt;0.001) and less comorbid than logEuroSCORE \u226520% patients, with a higher rate of transfemoral TAVI (35.6% vs 26.1%; p&lt;0.001) and predilation (70.0% vs 63.3%; p=0.004). Patients with a logEuroSCORE &lt;20% experienced more vascular complications (3.4% vs 1.5%; p=0.010). One-year survival was 88.3% in the logEuroSCORE &lt;20%\u2009and 81.8% in the logEuroSCORE \u226520% group (p=0.005), with the calculated mortality risk falling within 2% of the logEuroSCORE in just 12.9% of patients. In the logEuroSCORE &lt;20% group, only coronary artery disease was significantly predictive of 1-year mortality (OR 2.408; 95%\u2009CI 1.361 to 4.262; p=0.003).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>At our institution, patients with a logEuroSCORE &lt;20% selected for TAVI have excellent outcomes. The decision not to reimburse TAVI in such patients may be viewed as inappropriate.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2019-001194","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T04:05:23Z","timestamp":1582171523000},"page":"e001194","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical value of the 20% logistic EuroSCORE cut-off for selecting TAVI candidates: a single-centre cohort study analysis"],"prefix":"10.1136","volume":"7","author":[{"given":"Guram","family":"Imnadze","sequence":"first","affiliation":[{"name":"Institut f\u00fcr Gesundheitsforschung und Bildung, Universit\u00e4t Osnabr\u00fcck, Osnabr\u00fcck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Hofmann","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Sch\u00fcchtermann Clinic, Bad Rothenfelde, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Billion","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Sch\u00fcchtermann Clinic, Bad Rothenfelde, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas","family":"Ferdosi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Sch\u00fcchtermann Clinic, Bad Rothenfelde, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sch\u00fcchtermann Clinic, Bad Rothenfelde, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehab","family":"Rajab","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Sch\u00fcchtermann Clinic, Bad Rothenfelde, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Bramlage","sequence":"additional","affiliation":[{"name":"Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-2110","authenticated-orcid":false,"given":"Peter","family":"Bramlage","sequence":"additional","affiliation":[{"name":"Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henning","family":"Warnecke","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Sch\u00fcchtermann Clinic, Bad Rothenfelde, Germany"},{"name":"University Witten\/ Herdecke, Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Franz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sch\u00fcchtermann Clinic, Bad Rothenfelde, Germany"},{"name":"University Witten\/ Herdecke, Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"2025081710270617000_7.1.e001194.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00134-7"},{"key":"2025081710270617000_7.1.e001194.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.015"},{"key":"2025081710270617000_7.1.e001194.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn183"},{"key":"2025081710270617000_7.1.e001194.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"2025081710270617000_7.1.e001194.5","doi-asserted-by":"crossref","unstructured":"K\u00f6lbel R . Abrechnungsverst\u00f6\u00dfe in Der station\u00e4ren medizinischen Versorgung: Medizinische, \u00f6konomische und juristische Perspektiven. Kohlhammer Verlag, 2013.","DOI":"10.17433\/978-3-17-023865-7"},{"key":"2025081710270617000_7.1.e001194.6","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1093\/icvts\/ivx315","article-title":"Transapical transcatheter aortic valve implantation in patients with a low ejection fraction","volume":"26","author":"Imnadze","year":"2018","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2025081710270617000_7.1.e001194.7","doi-asserted-by":"crossref","first-page":"215","DOI":"10.5114\/kitp.2017.72224","article-title":"Transcatheter aortic valve implantation at a high-volume center: the bad Rothenfelde experience","volume":"4","author":"Kowalski","year":"2017","journal-title":"Kitp"},{"key":"2025081710270617000_7.1.e001194.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"2025081710270617000_7.1.e001194.9","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1056\/NEJMoa1700456","article-title":"Surgical or transcatheter aortic-valve replacement in intermediate-risk patients","volume":"376","author":"Reardon","year":"2017","journal-title":"N Engl J Med"},{"key":"2025081710270617000_7.1.e001194.10","first-page":"209","article-title":"Transcatheter aortic valve replacement versus surgical valve replacement in Low-Intermediate surgical risk patients: a systematic review and meta-analysis","volume":"29","author":"Garg","year":"2017","journal-title":"J Invasive Cardiol"},{"key":"2025081710270617000_7.1.e001194.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i5130"},{"key":"2025081710270617000_7.1.e001194.12","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter aortic-valve replacement with a Balloon-Expandable valve in low-risk patients","volume":"380","author":"Mack","year":"2019","journal-title":"N Engl J Med"},{"key":"2025081710270617000_7.1.e001194.13","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients","volume":"380","author":"Popma","year":"2019","journal-title":"N Engl J Med"},{"key":"2025081710270617000_7.1.e001194.14","first-page":"n\/a","article-title":"Incidence and predictors of permanent pacemaker implantation following transcatheter aortic valve implantation: analysis from the German transcatheter aortic valve interventions registry","volume":"82","author":"Ledwoch","year":"2013","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025081710270617000_7.1.e001194.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02211.x"},{"key":"2025081710270617000_7.1.e001194.16","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1053\/j.jvca.2015.06.001","article-title":"Predictors of permanent pacemaker implantation after transcatheter aortic valve replacement","volume":"29","author":"Hoyt","year":"2015","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2025081710270617000_7.1.e001194.17","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/pace.12653","article-title":"Incidence and predictors of pacemaker implantation in patients undergoing transcatheter aortic valve replacement","volume":"38","author":"Maan","year":"2015","journal-title":"Pacing Clin Electrophysiol"},{"key":"2025081710270617000_7.1.e001194.18","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-1-201301010-00007"},{"key":"2025081710270617000_7.1.e001194.19","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1016\/S0140-6736(16)30073-3","article-title":"Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis","volume":"387","author":"Thourani","year":"2016","journal-title":"The Lancet"},{"key":"2025081710270617000_7.1.e001194.20","doi-asserted-by":"crossref","unstructured":"Schymik G , W\u00fcrth A , Bramlage P , et al . Long-Term results of transapical versus transfemoral TAVI in a real world population of 1000 patients with severe symptomatic aortic stenosis. 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Transcatheter aortic valve implantation with or without preimplantation balloon aortic valvuloplasty: a systematic review and Meta\u2010Analysis. 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