{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:19:16Z","timestamp":1789154356110,"version":"build-2803163510"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Given their advanced age and high comorbidity, individual risk assessment is crucial in patients undergoing transcatheter mitral and tricuspid valve repair. Therefore, we evaluated the use of a comprehensive geriatric assessment score, the multidimensional prognostic index (MPI), for risk stratification in these patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We conducted a prospective, observational single-center study, including 226 patients undergoing percutaneous repair for mitral or tricuspid regurgitation. The MPI was calculated preprocedural and covers 8 domains (activities of daily living, instrumental activities of daily living, mental status, nutrition, risk of pressure ulcers, comorbidity, medication, and marital\/cohabitation status). We sought to identify an association of MPI score with procedural outcomes and 6-month mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              A total of 53.1% of patients were stratified as low risk according to MPI (MPI-1 group), 44.2% as medium risk (MPI-2 group), and 2.7% as high risk (MPI-3 group). Procedural efficacy and safety were similar between groups. The estimated survival rate at 6 months was 97\u00b12% in MPI-1 group, 79\u00b14% in MPI-2 group (hazard ratio, 6.90 [95% CI, 2.36\u201312.2];\n              <jats:italic>P<\/jats:italic>\n              \u22640.001) and 50\u00b120% in MPI-3 group (hazard ratio, 20.3 [95% CI, 4.51\u201391.3];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). An increase in 1 SD of the MPI score (0.14 points, possible range of MPI score 0\u20131) was associated with a hazard ratio of 2.13 (95% CI, 1.58\u20132.73;\n              <jats:italic>P<\/jats:italic>\n              \u22640.001) for death after 6 months. The risk association of the MPI with mortality remained significant in multivariate analysis including risk factors, such as peripheral artery disease and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>A comprehensive geriatric assessment with the MPI score provides additional information on mortality risk beyond established cardiovascular risk factors.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.120.007624","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T18:03:16Z","timestamp":1629223396000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Risk Stratification of Patients Undergoing Percutaneous Repair of Mitral and Tricuspid Valves Using a Multidimensional Geriatric Assessment"],"prefix":"10.1161","volume":"14","author":[{"given":"Matthieu","family":"Sch\u00e4fer","sequence":"first","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9073-9279","authenticated-orcid":true,"given":"Maria I.","family":"K\u00f6rber","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakave","family":"Vimalathasan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Mauri","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7655-8500","authenticated-orcid":true,"given":"Christos","family":"Iliadis","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Metze","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"ten Freyhaus","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8259-1737","authenticated-orcid":true,"given":"Stephan","family":"Baldus","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pneumology, Angiology, and Intensive Care, Department III of Internal Medicine (M.S., M.I.K., R.V., V.M., C.I., C.M., H.t.F., S.B., R.P.), Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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