Table 4.
Univariate and multivariable cox proportional hazard analysis for all-cause mortality
| Variables | Univariate analysis | Multivariate analysis | ||
|---|---|---|---|---|
| Hazard Ratio (95% CI) | p value | Hazard Ratio (95% CI) | p value | |
| Clinical variables | ||||
| Prior XRT | 1.94 (1.18–3.06) | 0.009 | 2.07 (1.24–3.31) | 0.005 |
| STS score (per unit change) | 1.04 (1.01–1.07) | 0.001 | 1.00 (0.96–1.03) | 0.93 |
| Age (per unit change) | 0.99 (0.97–1.02) | 0.7 | ||
| Gender (Male versus Female) | 1.2 (0.81–1.78) | 0.35 | ||
| BMI (kg/m2, per unit change) | 0.99 (0.96–1.03) | 0.9 | ||
| Hypertension | 1.21 (0.62–2.72) | 0.58 | ||
| Diabetes mellitus | 1.00 (0.66–1.50) | 0.96 | ||
| Hyperlipidemia | 1.54 (1.02–2.37) | 0.03 | 1.48 (0.96–2.31) | 0.07 |
| Smoking | 1.37 (0.92–2.04) | 0.11 | ||
| Prior Stroke | 1.60 (0.98–2.51) | 0.05 | ||
| COPD | 1.49 (1.01–2.20) | 0.04 | 1.21 (0.74–2.00) | 0.43 |
| CAD | 1.29 (0.86–1.97) | 0.21 | ||
| 3 Vessel CAD | 0.85 (0.53–1.32) | 0.49 | ||
| End stage renal disease | 3.03 (1.61–5.23) | 0.001 | 0.96 (0.28–2.92) | 0.94 |
| Peripheral artery disease | 1.24 (0.82–1.84) | 0.29 | ||
| Atrial Fibrillation | 1.30 (0.87–1.92) | 0.18 | ||
| Prior Cardiac surgery | 0.90 (0.59–1.36) | 0.65 | ||
| ICM (EF < 50% and CAD) | 1.25 (0.73–1.89) | 0.44 | ||
| Previous PCI | 1.03 (0.62–1.64) | 0.88 | ||
| Prior Pacemaker | 1.24 (0.74–1.99) | 0.38 | ||
| Angina | 0.97 (0.90–1.46) | 0.9 | ||
| Syncope | 1.21 (0.53–2.36) | 0.61 | ||
| Dyspnea on exertion | 1.37 (0.70–3.10) | 0.36 | ||
| Pre-TAVR KCCQ12 score (per unit change) | 0.37 (0.12–1.06) | 0.06 | ||
| Lab /Echo Variable | ||||
| Pre-TAVR Hb (gm, per unit change) | 0.79 (0.70–0.89) | 0.0002 | 090 (0.78–1.04) | 0.17 |
| Creatinine (per unit change) | 1.22 (1.09–1.33) | 0.0006 | 0.87 (0.66–1.13) | 0.32 |
| eGFR (per unit change) | 0.99 (0.98–1.00) | 0.13 | ||
| FEV1 (per unit change) | 0.98 (0.98–0.99) | 0.01 | 0.99 (0.98–1.00) | 0.43 |
| LV EF (%, per unit change) | 0.99 (0.98–1.01) | 0.59 | ||
| AR (per level increase in severity) | 1.26 (0.71–2.24) | 0.06 | ||
| Presence of MS | 1.80 (0.96–3.12) | 0.06 | ||
| MR (per level increase in severity) | 1.32 (0.69–2.51) | 0.33 | ||
| TR (per level increase in severity) | 0.81 (0.41–1.58) | 0.36 | ||
| AVA (cm2, per unit change) | 1.38 (0.47–3.87) | 0.54 | ||
| Mean AV gradient (mmHg, per unit change) | 0.99 (0.98–1.00) | 0.43 | ||
| Peak AV gradient (mmHg, per unit change) | 0.99 (0.99–1.00) | 0.88 | ||
| Reduced LV-SVI | 1.13 (0.76–1.67) | 0.51 | ||
| RVSP (mmHg, per unit change) | 1.01 (1.00–1.02) | 0.01 | 1.01 (0.99–1.02) | 0.05 |
| Medications | ||||
| Aspirin | 1.15 (0.76–1.78) | 0.5 | ||
| Beta-Blocker | 1.37 (0.79–2.58) | 0.27 | ||
| Statins | 1.52 (0.99–2.32) | 0.05 | ||
| ACE/ARBs | 1.05 (0.69–1.57) | 0.81 | ||
| Operative and Post-Operative variables | ||||
| Operative time (in hours, per unit change) | 1.00 (0.99–1.00) | 0.09 | ||
| TVT Access (Femoral vs others) | 1.07 (0.63–1.94) | 0.8 | ||
| Type of Valve (Edward Sapiens vs Core valve) | 0.77 (0.48–1.29) | 0.31 | ||
| Para-valvular leak (mod-severe) | 0.58 (0.09–2.01) | 0.18 | ||
| Post Op Atrial fibrillation | 1.55 (0.82–2.68) | 0.16 | ||
| Creatinine at discharge (mg, per unit change) | 1.33 (1.19–1.47) | < 0.001 | 1.43 (1.11–1.85) | 0.004 |
| Post procedure Hb (gm, per unit change) | 0.82 (0.72–0.92) | 0.001 | 1.03 (0.87–1.23) | 0.66 |
| Per units’ blood transfused | 1.22 (1.12–1.32) | < 0.0001 | 1.17 (1.05–1.30) | 0.003 |
| Post-LVEF (%, per unit change) | 0.99 (0.97–1.00) | 0.29 | ||
Chi-square for the overall multivariate model was 54.82, p < 0.0001. XRT indicates mediastinal radiation exposure
STS Society of Thoracic Surgeons, BMI body mass index, CAD coronary artery disease, COPD chronic obstructive pulmonary disease, ICM ischemic cardiomyopathy, PCI percutaneous coronary intervention, Hb hemoglobin, LVEF left ventricular ejection fraction, AVA aortic valve area, AV aortic valve, LV-SVI left ventricular stroke volume index, RVSP right ventricular systolic pressure, AR aortic regurgitation, MR mitral regurgitation, TR tricuspid regurgitation, MS mitral stenosis, FEV1 forced expiratory volume at 1 s, KCCQ12 Kansas City Cardiomyopathy Questionnaire