AIMS We aimed to validate a new scoring system based on extent of cardiac damage for risk stratification in patients undergoing transcatheter aortic valve replacement (TAVR) in a real-world cohort and to examine the addition of baseline albumin in risk assessment. METHODS AND RESULTS We investigated 2608 patients undergoing TAVR. Subjects were divided into five groups based on their echocardiography findings. Patients were further assessed by incorporating baseline albumin. Multivariable analysis demonstrated that each increase in stage was associated with significant increased risk of 1-year mortality (HR 1.37, 95%CI 1.23-1.54, p < .001). Among patients at increased stage (3-4), incorporation of baseline of albumin identified the highest risk group, such that each 1 decrement in albumin levels was associated with more than triple increase in mortality among patients at stage 3 and 4 (HR 2.77, 95% CI 1.48-5.18, p-value = .001). CONCLUSIONS Cardiac damage classification is validated in a real-world cohort of patients undergoing TAVR. Incorporation of low baseline albumin may further identify patients at the highest risk group. CONDENSTED ABSTRACT We evaluated 2608 patients undergoing transcatheter aortic valve replacement (TAVR) in order to validate a new scoring system dividing patients in to 5 stages (0-4) based on extent of cardiac damage. Patients were further assessed by incorporating baseline albumin. Multivariable analysis demonstrated that each increase in stage was associated with significant increased risk of 1-year mortality. Furthermore, among patients at increased stage (3-4), incorporation of baseline of albumin identified the highest risk group, such that each 1 decrement in albumin levels was associated with more than triple increase in mortality among patients at stage 3 and 4.

中文翻译：

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在接受经导管主动脉瓣置换术的大量患者中验证心脏损伤分类和添加白蛋白。

目的 我们旨在验证一种基于心脏损伤程度的新评分系统，用于在真实世界队列中接受经导管主动脉瓣置换术 (TAVR) 的患者进行风险分层，并检查在风险评估中添加基线白蛋白。方法和结果 我们调查了 2608 名接受 TAVR 的患者。根据他们的超声心动图结果将受试者分为五组。通过纳入基线白蛋白进一步评估患者。多变量分析表明，每个阶段的增加都与 1 年死亡率风险显着增加相关（HR 1.37, 95%CI 1.23-1.54, p < .001）。在增加阶段（3-4）的患者中，结合白蛋白基线确定了最高风险组，因此，在第 3 和第 4 期患者中，白蛋白水平每下降 1 倍，死亡率就会增加三倍以上（HR 2.77，95% CI 1.48-5.18，p 值 = .001）。结论 心脏损伤分类在接受 TAVR 的真实患者队列中得到验证。结合低基线白蛋白可以进一步识别处于最高风险组的患者。简明摘要 我们评估了 2608 名接受经导管主动脉瓣置换术 (TAVR) 的患者，以验证一种根据心脏损伤程度将患者分为 5 个阶段 (0-4) 的新评分系统。通过纳入基线白蛋白进一步评估患者。多变量分析表明，每个阶段的增加都与 1 年死亡率的风险显着增加有关。此外，在增加阶段（3-4）的患者中，