Clinical Interventions in Aging · Oct 29, 2026

Prognostic Value of the Frailty Index in Patients with Severe Aortic Regurgitation Undergoing Transcatheter Aortic Valve Replacement

By Yu Q, Fu Q, Cheng Z et al.

BACKGROUND: Frailty represents a multidimensional vulnerability that predicts poor outcomes in cardiovascular disease. Its prognostic value in patients with severe native aortic regurgitation (AR) undergoing transcatheter aortic valve replacement (TAVR) is not well defined. OBJECTIVE: To determine whether an abbreviated cumulative deficit frailty index predicts one-year all-cause mortality and to explore its interaction with N-terminal pro-B-type natriuretic peptide in this population. METHODS: In this post hoc analysis of the prospective China DVD2 multicenter cohort, 298 patients with isolated severe AR who underwent TAVR were included. Frailty was assessed preprocedurally using an abbreviated 8-9-item cumulative deficit frailty index (FI) encompassing functional, cognitive, nutritional, and clinical domains. The primary endpoint was one-year all-cause mortality. The cohort-derived FI threshold for mortality was derived using time-dependent receiver operating characteristic analysis. Cox proportional hazards models adjusted for age, sex, body mass index, atrial fibrillation, and NT-proBNP were applied. Subgroup and interaction analyses were performed. RESULTS: The cohort-derived FI threshold was 0.407, classifying 32 patients as high frailty. High-FI patients exhibited greater symptom burden, higher prevalence of atrial fibrillation, larger left atrial diameter, and elevated NT-proBNP. One-year mortality was significantly higher in the high-FI group compared with low-FI patients (15.6% vs 3.4%, P = 0.010). High FI was associated with higher one-year mortality in Model 3 (HR 4.00, 95% CI 1.18-13.50; P = 0.026). No significant multiplicative or additive interaction with NT-proBNP was observed. CONCLUSIONS: Among patients undergoing TAVR for severe native aortic regurgitation, a high FI was associated with higher one-year mortality. These findings extend prior evidence on the prognostic implications of frailty to this understudied population.

doi.org/10.2147/cia.s643768 Open access PubMed 42974471 Biomarkers