SavedAdd your journal

Journals / Anatolian Current Medical Journal / 2026 / Volume: 8 Issue: 4

Prognostic value of SCORE2 and SCORE2-OP in patients with severe aortic stenosis undergoing transcatheter or surgical aortic valve replacement

Anar Mammadli(Bayındır Söğütözü Hospital, Ankara, Türkiye)0000-0002-1351-1905
Ayşe İrem Demirtola(University of Health Sciences Ankara City Hospital - Cardiology Department)0000-0003-4846-0770
Duygu İnan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0000-0003-3921-6469
İhsan Demirtaş(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0009-0009-4025-8958
Berk Erdinç(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0000-0001-7422-0610
Onur Yıldırım(Liv Hospital, Ankara, Türkiye)0000-0002-9750-5413
Alev Kılıçgedik(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI)0000-0002-0654-8128
Pages
—
Publication Date
2026-07-16
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Very high SCORE2 risk remained significantly associated with mid-term mortality in patients with severe AS undergoing TAVI or SAVR, suggesting that global cardiovascular risk assessment may provide complementary prognostic information after valve intervention.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: Despite advances in valve intervention strategies, mortality in patients with severe aortic stenosis remains considerable.
📊
Key Findings & Data:The present study investigated whether age-appropriate SCORE2 risk classification provides prognostic information in patients with severe AS undergoing either transcatheter or surgical aortic valve replacement.
💡
Conclusion & Impact:Conclusion: Very high SCORE2 risk remained significantly associated with mid-term mortality in patients with severe AS undergoing TAVI or SAVR, suggesting that global cardiovascular risk assessment may provide complementary prognostic information after valve intervention.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Aortic stenosis · SCORE2 · transcatheter aortic valve implantation

Abstract

Aims: Despite advances in valve intervention strategies, mortality in patients with severe aortic stenosis remains considerable. The present study investigated whether age-appropriate SCORE2 risk classification provides prognostic information in patients with severe AS undergoing either transcatheter or surgical aortic valve replacement. Methods: This retrospective single-center study included 168 consecutive patients with severe AS who underwent surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Cardiovascular risk was estimated using age-appropriate SCORE2 algorithms (SCORE2 for patients aged <70 years and SCORE2-OP for those ≥70 years). Patients were classified into non-very high-risk and very high-risk groups. The primary endpoint was all-cause mortality during follow-up. Survival analyses were performed using Kaplan-Meier methods and Cox proportional hazards regression. Results: Among 168 patients (median age 73 [63-80] years; 51% male), 116 (69%) were classified as very high risk. During a median follow-up of 10 (4-16) months, 28 patients (17%) died. Mortality was higher in the very high-risk group (21% vs. 8%; p =0.02), with lower cumulative survival (log-rank p=0.03). In Cox analysis, very high SCORE2 risk predicted mortality (HR 3.22, 95% CI 1.11-9.30; p=0.031) and remained significant after adjustment (HR 3.40, 95% CI 1.11-10.41; p=0.032). Model discrimination improved after adjustment (AUC 0.60 to 0.70). Conclusion: Very high SCORE2 risk remained significantly associated with mid-term mortality in patients with severe AS undergoing TAVI or SAVR, suggesting that global cardiovascular risk assessment may provide complementary prognostic information after valve intervention.

🔖

Cite This Article

Mammadli, A., Demirtola, A. İ., İnan, D., Demirtaş, İ., Erdinç, B., Yıldırım, O., Kılıçgedik, A. (2026). Prognostic value of SCORE2 and SCORE2-OP in patients with severe aortic stenosis undergoing transcatheter or surgical aortic valve replacement. Anatolian Current Medical Journal, Volume: 8 Issue: 4. https://doi.org/10.38053/acmj.1919093

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (20)

  1. Généreux P, Sharma RP, Cubeddu RJ, et al. The mortality burden of untreated aortic stenosis. J Am Coll Cardiol. 2023;82(22):2101-2109. doi:10.1016/j.jacc.2023.09.796
  2. Thourani VH, Habib R, Szeto WY, et al. Survival after surgical aortic valve replacement in low-risk patients: a contemporary trial benchmark. Ann Thorac Surg. 2024;117(1):106-112. doi:10.1016/j.athoracsur.2023.10.006
  3. Forrest JK, Yakubov SJ, Deeb GM, et al. 5-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients with aortic stenosis. J Am Coll Cardiol. 2025;85(15):1523-1532. doi:10.1016/j.jacc.2025.03.004
  4. Thogata H, Garikipati S, Reddy SS, Abhinav Reddy P, Kumar Jella H. Long-term prognosis and predictors of mortality in patients undergoing transcatheter aortic valve replacement: a retrospective analysis. Cureus. 2023;15(8):e44432. doi:10.7759/cureus.44432
  5. Duchnowski P, Hryniewiecki T, Kuśmierczyk M, Szymanski P. Performance of the EuroSCORE II and the Society of Thoracic Surgeons score in patients undergoing aortic valve replacement for aortic stenosis. J Thorac Dis. 2019;11(5):2076-2082. doi:10.21037/jtd.2019.04.48
  6. SCORE2 Working Group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42(25):2439-2454. doi:10.1093/eurheartj/ehab309
  7. Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021; 42(34):3227-3337. doi:10.1093/eurheartj/ehab484
  8. Praz F, Borger MA, Lanz J, et al. 2025 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2025;46(44):4635-4736. doi:10.1093/eurheartj/ehaf194
  9. Nijskens CM, Wiersinga JHI, MacNeil-Vroomen JL, et al. External validation of SCORE2-OP for predicting cardiovascular mortality in frail geriatric outpatients. J Am Med Dir Assoc. 2026;27(4):106102. doi:10.1016/j.jamda.2025.106102
  10. Zheng F, Xie W, Li C, Gao D, Liang J. Prediction abilities of SCORE2 risk algorithms for incident dementia and all-cause mortality: results from the UK Biobank cohort study. J Gerontol A Biol Sci Med Sci. 2023;78(4): 704-710. doi:10.1093/gerona/glac251
  11. Shu L, Yuan Z, Li F, Cai Z. Oxidative stress and valvular endothelial cells in aortic valve calcification. Biomed Pharmacother. 2023;163:114775. doi:10.1016/j.biopha.2023.114775
  12. Quast C, Bönner F, Polzin A, et al. Aortic valve stenosis causes accumulation of extracellular hemoglobin and systemic endothelial dysfunction. Circulation. 2024;150(12):952-965. doi:10.1161/CIRCULATIONAHA.123.064747
  13. Zornitzki L, Ben-Shoshan J. Predictors of long-term survival in patients undergoing TAVR: recent advances. Kardiol Pol. 2025;83(10):1134-1141. doi:10.33963/v.phj.108744
  14. Shvartz V, Sokolskaya M, Petrosyan A, et al. Predictors of mortality following aortic valve replacement in aortic stenosis patients. Pathophysiology. 2022;29(1):106-117. doi:10.3390/pathophysiology29010010
  15. Kahraman E, Polat F, Uzman O, Çam R, Özdemir GM, Velibey Y. Predictive value of the Naples Prognostic Score for 30-day mortality and major adverse cardiovascular events in patients undergoing transcatheter aortic valve implantation for severe aortic stenosis. Turk Kardiyol Dern Ars. 2026;54(2):109-120. doi:10.5543/tkda.2025.00266
  16. Abu Khadija H, Najajra D, Masu’d M, et al. Triglyceride-glucose index predicts early, short-term, and long-term mortality after transcatheter aortic valve replacement. Am Heart J Plus. 2025;61:100684. doi:10.1016/j.ahjo.2025.100684
  17. Akdoğan M, Yücel EC, Taş A, et al. Osaka Prognostic Score predicts in-hospital and one-year mortality following transcatheter aortic valve implantation. Medicina (Kaunas). 2025;61(12):2142. doi:10.3390/medicina61122142
  18. Yamauchi T, Takano H, Miyata H, Motomura N, Takamoto S. Risk factors for mortality and morbidity of surgical aortic valve replacement for aortic stenosis: risk model from a Japan Cardiovascular Surgery Database. Circ Rep. 2019;1(3):131-136. doi:10.1253/circrep.cr-19-0010
  19. Kleczynski P, Dziewierz A, Bagienski M, et al. Impact of frailty on mortality after transcatheter aortic valve implantation. Am Heart J. 2017;185:52-58. doi:10.1016/j.ahj.2016.12.005
  20. Li Z, Dawson E, Moodie J, et al. Frailty in patients undergoing transcatheter aortic valve implantation: a protocol for a systematic review. BMJ Open. 2019;9(2):e024163. doi:10.1136/bmjopen-2018-024163