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Aortic Valve Calcification Scores versus CT-FFR: Prediction of Major Adverse Cardiovascular Events after

Shuangxin Li1, Xugang Wang1, Wenxuan Yang1

  • 1Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

Cardiology
|February 3, 2026
PubMed

Insights

Aortic valve calcification (AVC) score and CT-FFR predict major adverse cardiovascular events (MACE) after TAVR. CT-FFR offers additional prognostic value, aiding risk management for TAVR patients.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic valve disease.
  • Assessing prognosis after TAVR is crucial for patient management.
  • Aortic valve calcification (AVC) score and CT angiography-derived fractional flow reserve (CT-FFR) are potential prognostic markers.

Purpose of the Study:

  • To evaluate the prognostic value of AVC score and CT-FFR for major adverse cardiovascular events (MACE) following TAVR.
  • To determine if CT-FFR provides incremental prognostic information beyond clinical risk factors and AVC score.

Main Methods:

  • Retrospective observational cohort study of 251 patients undergoing TAVR.
  • Follow-up for a composite endpoint of MACE (all-cause mortality, MI, unstable angina, HF rehospitalization).
  • Univariable and multivariate Cox regression analysis, including assessment of incremental prognostic value.

Main Results:

  • 60 patients (23.9%) experienced MACE during a mean 36-month follow-up.
  • AVC score ≥ 2000 (HR=1.714, P=0.042) and CT-FFR ≤ 0.8 (HR=3.248, P<0.001) independently predicted MACE.
  • CT-FFR demonstrated incremental prognostic value over clinical factors alone and combined with AVC score (C-indices 0.710 vs 0.645/0.672, P<0.05).

Conclusions:

  • Both AVC score and CT-FFR are associated with MACE post-TAVR.
  • CT-FFR offers significant incremental prognostic value for predicting MACE after TAVR.
  • CT-FFR should be integrated into routine clinical decision-making and risk stratification for TAVR patients.
Abstract

Keywords:
Aortic valve calcification scoreCT angiography-derived fractional flow reserveMajor adverse cardiovascular eventsTranscatheter aortic valve replacement

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