Valvular & structural heart disease
The Impact of Clinical and Biochemical Frailty on Outcomes following Transcatheter Aortic Valve Replacement
Authors' conclusion
Frailty is common with significant implications in TAVR. Patients with biochemical and clinical frailty criteria are highest risk. Development of strategies to address frailty is critical.
Study context
- Population
- Contemporary TAVR patients
- Participants
- 2,661 patients
- Exposure
- Increasing frailty: no frailty vs biochemical frailty (BF) or clinical frailty (CF) vs BF + CF
- Frailn = 920
- BF + CFn = 171
- Outcome
- Mortality
- Follow-up
- 12 months
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)P value
BF or CF
1.6(1.0–2.4)
P = 0.033BF + CF
3.3(1.9–5.6)
P < 0.001Observational data: associations, not effects.
Further findings
Mortality prediction with addition of frailty to STS Score
- Area under the receiver-operating characteristic curve
- 0.608 vs 0.664; DeLong's P = 0.021
- Shapley analysis demonstrating significant contribution from frailty
Cohort characteristics
- Median age
- 82 (IQR: 77-86)
- Male
- 60%
- Median STS
- 3.3 (2-5.2)
Frailty prevalence
- Considered frail
- 920 patients (35%)
- Of frail patients, fulfilled both BF and CF criteria
- 171 (19%)
Characteristics of the frail group
- The frail group was older
- 83 vs 81, P < 0.001
- More females
- 43% vs 38%; P = 0.016
- Higher STS scores
- 4 vs 3, P < 0.001
Original publication
The Impact of Clinical and Biochemical Frailty on Outcomes following Transcatheter Aortic Valve Replacement. JACC Adv. Published 2 November 2026. doi:10.
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