The MIDA Mortality Risk Score: development and external validation of a prognostic model for early and late death in degenerative mitral regurgitation - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue European Heart Journal Année : 2018

The MIDA Mortality Risk Score: development and external validation of a prognostic model for early and late death in degenerative mitral regurgitation

(1) , (2) , (3, 4, 5, 6) , (7, 8) , , , (9) , (10) , , (11, 12) , (13, 14) , , , (15) , , , , (7) , , , , (16) ,
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Rodolfo Pizarro
  • Fonction : Auteur
Marianne Huebner
  • Fonction : Auteur
Andrea Barbieri
Rakesh Suri
  • Fonction : Auteur
Gaetano D. Gargiulo
  • Fonction : Auteur
Pablo Oberti
  • Fonction : Auteur
Alexis Theron
Francesca Bursi
  • Fonction : Auteur
Hector Michelena
  • Fonction : Auteur
Siham Lazam
  • Fonction : Auteur
Catherine Szymanski
Vuyisile T. Nkomo
  • Fonction : Auteur
Martin Schumacher
  • Fonction : Auteur
Letizia Bacchi-Reggiani
  • Fonction : Auteur
Mida Investigators
  • Fonction : Auteur

Résumé

Aims In degenerative mitral regurgitation (DMR), lack of mortality scores predicting death favours misperception of individual patients' risk and inappropriate decision-making. Methods and results The Mitral Regurgitation International Database (MIDA) registries include 3666 patients (age 66 +/- 14 years; 70% males; follow-up 7.8 +/- 5.0 years) with pure, isolated, DMR consecutively diagnosed by echocardiography at tertiary (European/North/South-American) centres. The MIDA Score was derived from the MIDA-Flail-Registry (2472 patients with DMR and flail leaflet-Derivation Cohort) by weighting all guideline-provided prognostic markers, and externally validated in the MIDA-BNP-Registry (1194 patients with DMR and flail leaflet/prolapse-Validation Cohort). The MIDA Score ranged from 0 to 12 depending on accumulating risk factors. In predicting total mortality post-diagnosis, the MIDA Score showed excellent concordance both in Derivation Cohort (c = 0.78) and Validation Cohort (c = 0.81). In the whole MIDA population (n = 3666 patients), 1-year mortality with Scores 0, 7-8, and 11-12 was 0.4, 17, and 48% under medical management and 1, 7, and 14% after surgery, respectively (P < 0.001). Five-year survival with Scores 0, 7-8, and 11-12 was 98 +/- 1, 57 +/- 4, and 21 +/- 10% under medical management and 99 +/- 1, 82 +/- 2, and 57 +/- 9% after surgery (P < 0.001). In models including all guideline-provided prognostic markers and the EuroScoreII, the MIDA Score provided incremental prognostic information (P <= 0.002). Conclusion The MIDA Score may represent an innovative tool for DMR management, being able to position a given patient within a continuous spectrum of short-and long-term mortality risk, either under medical or surgical management. This innovative prognostic indicator may provide a specific framework for future clinical trials aiming to compare new technologies for DMR treatment in homogeneous risk categories of patients.

Dates et versions

hal-03580340 , version 1 (18-02-2022)

Identifiants

Citer

Francesco Grigioni, Marie-Annick Clavel, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Rodolfo Pizarro, et al.. The MIDA Mortality Risk Score: development and external validation of a prognostic model for early and late death in degenerative mitral regurgitation. European Heart Journal, 2018, 39 (15), pp.1281-1291. ⟨10.1093/eurheartj/ehx465⟩. ⟨hal-03580340⟩
17 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook Twitter LinkedIn More