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Related Experiment Video

Updated: Jan 28, 2026

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Comparing Frailty Markers in Predicting Poor Outcomes after Transcatheter Aortic Valve Replacement.

Aravind Krishnan1, Alejandro Suarez-Pierre1, Xun Zhou1

  • 11 Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Innovations (Philadelphia, Pa.)
|March 9, 2019
PubMed
Summary

Sarcopenia of the psoas muscles and albumin levels are better predictors of mortality after transcatheter aortic valve replacement (TAVR) than the modified Frailty Index (mFI). These objective markers offer improved risk prognostication for TAVR patients.

Keywords:
TAVRfrailtyoutcomes

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Area of Science:

  • Cardiology
  • Geriatrics
  • Radiology

Background:

  • Frailty is a critical factor in risk stratification for transcatheter aortic valve replacement (TAVR).
  • Objective frailty markers like sarcopenia, modified Frailty Index (mFI), and albumin levels are increasingly used.
  • Comparative data on the predictive power of these markers post-TAVR is limited.

Purpose of the Study:

  • To define and compare objective frailty markers for predicting long-term outcomes after TAVR.
  • To establish novel cutoffs for sarcopenia using computed tomography (CT) scans.
  • To evaluate the association of sarcopenia, mFI, and albumin with 2-year all-cause mortality post-TAVR.

Main Methods:

  • Retrospective analysis of 381 patients undergoing TAVR (2011-2016).
  • Sarcopenia assessed via indexed cross-sectional areas of lumbosacral muscles on preoperative CT scans.
  • mFI calculated using an 11-point clinical scale; albumin levels measured preoperatively.
  • Survival analysis used to determine associations with 2-year mortality.

Main Results:

  • Psoas muscle sarcopenia was linked to increased mortality risk (multivariate HR: 2.5, P = 0.01).
  • Paravertebral muscle sarcopenia showed univariate association with mortality (HR: 2.1, P = 0.03).
  • Higher preoperative albumin levels correlated with decreased mortality risk (multivariate HR: 0.3, P < 0.01).
  • The mFI was not significantly associated with mortality.

Conclusions:

  • Novel cutoffs for psoas muscle sarcopenia predict decreased survival post-TAVR.
  • Sarcopenia and albumin levels demonstrate superior predictive value for TAVR outcomes compared to mFI.
  • Objective frailty markers offer enhanced risk prognostication in TAVR patients.