Age-Related Outcomes After Transcatheter Aortic Valve Replacement: Insights From the SwissTAVI Registry.
Details
Serval ID
serval:BIB_A1A474DF2160
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Age-Related Outcomes After Transcatheter Aortic Valve Replacement: Insights From the SwissTAVI Registry.
Journal
JACC. Cardiovascular interventions
ISSN
1876-7605 (Electronic)
ISSN-L
1936-8798
Publication state
Published
Issued date
10/05/2021
Peer-reviewed
Oui
Volume
14
Number
9
Pages
952-960
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
The aim of this study was to investigate age-related outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) as assessed in a nationwide, prospective, multicenter cohort study.
TAVR is the preferred treatment for elderly patients with severe aortic stenosis and is expanding into lower age groups.
Data from the SwissTAVI Registry were analyzed. Clinical outcomes were compared between patients 70 years of age or younger (n = 324), 70 to 79 years of age (n = 1,913), 80 to 89 years of age (n = 4,353), and older than 90 years of age (n = 507). Observed deaths were correlated with expected deaths in the general Swiss population using standardized mortality ratios.
Between February 2011 and June 2018, 7,097 patients (mean age 82.0 ± 6.4 years, 49.6% women) underwent TAVR at 15 hospitals in Switzerland. Procedural characteristics were similar; however, older patients more often had discharge to the referring hospital or a rehabilitation facility after TAVR. Using adjusted analyses, a linear trend for mortality (30-day adjusted hazard ratio [HR <sub>adj</sub> ]: 1.45; 95% confidence interval [CI]: 1.18 to 1.77; 1-year HR <sub>adj</sub> : 1.12; 95% CI: 1.01 to 1.24), cerebrovascular accidents (30-day HR <sub>adj</sub> : 1.35; 95% CI: 1.09 to 1.66; 1-year HR <sub>adj</sub> : 1.21; 95% CI: 1.02 to 1.45), and pacemaker implantation (30-day HR <sub>adj</sub> : 1.23; 95% CI: 1.12 to 1.34; 1-year HR <sub>adj</sub> : 1.19; 95% CI: 1.09 to 1.30) was observed with increasing age. Furthermore, standardized mortality ratios were 12.63 (95% CI: 9.06 to 17.58), 4.09 (95% CI: 3.56 to 4.74), 1.63 (95% CI: 1.50 to 1.78), and 0.93 (95% CI: 0.76 to 1.14) for TAVR patients in relation to the Swiss population <70, 70 to 79, 80 to 89 and ≥90 years of age, respectively.
Increasing age is associated with a linear trend for mortality, stroke, and pacemaker implantation during early and longer-term follow-up after TAVR. Standardized mortality ratios were higher for TAVR patients younger than 90 years of age compared with expected rates of mortality in an age- and sex-matched Swiss population. (SWISS TAVI Registry; NCT01368250).
TAVR is the preferred treatment for elderly patients with severe aortic stenosis and is expanding into lower age groups.
Data from the SwissTAVI Registry were analyzed. Clinical outcomes were compared between patients 70 years of age or younger (n = 324), 70 to 79 years of age (n = 1,913), 80 to 89 years of age (n = 4,353), and older than 90 years of age (n = 507). Observed deaths were correlated with expected deaths in the general Swiss population using standardized mortality ratios.
Between February 2011 and June 2018, 7,097 patients (mean age 82.0 ± 6.4 years, 49.6% women) underwent TAVR at 15 hospitals in Switzerland. Procedural characteristics were similar; however, older patients more often had discharge to the referring hospital or a rehabilitation facility after TAVR. Using adjusted analyses, a linear trend for mortality (30-day adjusted hazard ratio [HR <sub>adj</sub> ]: 1.45; 95% confidence interval [CI]: 1.18 to 1.77; 1-year HR <sub>adj</sub> : 1.12; 95% CI: 1.01 to 1.24), cerebrovascular accidents (30-day HR <sub>adj</sub> : 1.35; 95% CI: 1.09 to 1.66; 1-year HR <sub>adj</sub> : 1.21; 95% CI: 1.02 to 1.45), and pacemaker implantation (30-day HR <sub>adj</sub> : 1.23; 95% CI: 1.12 to 1.34; 1-year HR <sub>adj</sub> : 1.19; 95% CI: 1.09 to 1.30) was observed with increasing age. Furthermore, standardized mortality ratios were 12.63 (95% CI: 9.06 to 17.58), 4.09 (95% CI: 3.56 to 4.74), 1.63 (95% CI: 1.50 to 1.78), and 0.93 (95% CI: 0.76 to 1.14) for TAVR patients in relation to the Swiss population <70, 70 to 79, 80 to 89 and ≥90 years of age, respectively.
Increasing age is associated with a linear trend for mortality, stroke, and pacemaker implantation during early and longer-term follow-up after TAVR. Standardized mortality ratios were higher for TAVR patients younger than 90 years of age compared with expected rates of mortality in an age- and sex-matched Swiss population. (SWISS TAVI Registry; NCT01368250).
Keywords
Aged, Aged, 80 and over, Aortic Valve/diagnostic imaging, Aortic Valve/surgery, Aortic Valve Stenosis/diagnostic imaging, Aortic Valve Stenosis/surgery, Cohort Studies, Female, Humans, Male, Prospective Studies, Registries, Risk Assessment, Risk Factors, Time Factors, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome, age, aortic stenosis, transcatheter aortic valve replacement
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Create date
26/04/2021 12:17
Last modification date
09/01/2024 8:15
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