Long-term Outcomes Following Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Atheroma.
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| Názov: | Long-term Outcomes Following Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Atheroma. |
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| Autori: | Kikuchi S; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France. Electronic address: sukeoshin@yahoo.co.jp., Trimaille A; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France., Carmona A; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Truong DP; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; Vietnam National Heart Institute, Bach Mai Hospital, Hanoï, Vietnam; Department of Cardiology, Hanoï Medical University, Hanoï, Vietnam., Matsushita K; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan., Marchandot B; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France., Granier A; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Vu MC; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Zheng F; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Heyberger Z; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Sun JTS; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Loizon F; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Knellwolf P; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Recht D; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Koenig B; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France., Hibi K; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan; Department of Cardiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Leddet P; Department of Cardiology, Hospital of Haguenau, Haguenau, France., De Poli F; Department of Cardiology, Hospital of Haguenau, Haguenau, France., Jesel L; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France., Ohlmann P; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France., Morel O; Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; UR 3074 Translational Cardiovascular Medicine, CRBS, University of Strasbourg, France; Department of Cardiology, Hanoï Medical University, Hanoï, Vietnam. |
| Zdroj: | The American journal of cardiology [Am J Cardiol] 2025 Dec 01; Vol. 256, pp. 23-30. Date of Electronic Publication: 2025 Jul 13. |
| Spôsob vydávania: | Journal Article |
| Jazyk: | English |
| Informácie o časopise: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0207277 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1913 (Electronic) Linking ISSN: 00029149 NLM ISO Abbreviation: Am J Cardiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Excerpta Medica |
| Výrazy zo slovníka MeSH: | Transcatheter Aortic Valve Replacement* , Plaque, Atherosclerotic*/complications , Plaque, Atherosclerotic*/diagnostic imaging , Aortic Valve Stenosis*/surgery , Aortic Valve Stenosis*/complications , Postoperative Complications*/epidemiology , Aortic Diseases*/complications, Humans ; Male ; Female ; Aged, 80 and over ; Aged ; Severity of Illness Index ; Retrospective Studies ; Risk Factors ; Ischemic Stroke/epidemiology ; Stroke/epidemiology ; Time Factors ; Treatment Outcome |
| Abstrakt: | Competing Interests: Declaration of competing interest S.K. has received a grant from the Japan Heart Foundation/Bayer Yakuhin Research Grant Abroad. O.M. has received grants from AstraZeneca, Medtronic and Boehringer Ingelheim. O.M's institution has been awarded grants by “Fondation Cœur et Recherche” and “Endofrance,” two reputable charities in France committed to advancing research initiatives. Although aorta atheroma morphology is associated with acute outcomes post-transcatheter aortic valve replacement (TAVR), its association with long-term outcomes post-TAVR remains unknown. This study evaluates the impact of severe aortic atheroma on long-term outcomes following TAVR. We enrolled 977 patients who underwent TAVR between February 2010 and May 2019, with available contrast-enhanced computed tomography data. Severe aortic atheroma was defined as protruding atheroma of ≥3mm thickness with protruding components, ulcerated atheroma with ulcer-like intimal disruption, and atheroma of ≥5mm thickness. The primary endpoint was 2-year major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of cardiovascular death, myocardial infarction, ischemic stroke, and heart failure, events classified as periprocedural (≤30 days), early (30 days to 1 year), and late (>1-year post-TAVR). Patients with severe aortic atheroma (n = 274, 28%) had a higher cumulative incidence of 2-year MACCE than those without (40.6% vs 28.9%, log-rank p = 0.0002), which was attributed to increased risks of ischemic stroke (13.8% vs 6.8%, log-rank p = 0.0012) and cardiovascular death (18.6% vs 10.8%, log-rank p = 0.0009). Severe aortic atheroma was an independent risk factors for 2-year MACCE (adjusted hazard ratio [aHR], 1.49, 95% CI 1.16 to 1.90). In the landmark analysis, severe aortic atheroma was independently associated with periprocedural ischemic stroke and cardiovascular death (aHR, 2.12, 95% CI 1.15 to 3.90 and aHR, 3.29, 95% CI 1.70 to 6.37, respectively), and late ischemic stroke (aHR, 3.71, 95% CI 1.35 to 10.2). Patients with severe aortic atheroma have an increased risk of 2-year MACCE post-TAVR. (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: MACCE; aortic atheroma; cardiovascular death; ischemic stroke; transcatheter aortic valve replacement |
| Entry Date(s): | Date Created: 20250715 Date Completed: 20251114 Latest Revision: 20251114 |
| Update Code: | 20251115 |
| DOI: | 10.1016/j.amjcard.2025.07.009 |
| PMID: | 40664269 |
| Databáza: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Competing Interests: Declaration of competing interest S.K. has received a grant from the Japan Heart Foundation/Bayer Yakuhin Research Grant Abroad. O.M. has received grants from AstraZeneca, Medtronic and Boehringer Ingelheim. O.M's institution has been awarded grants by “Fondation Cœur et Recherche” and “Endofrance,” two reputable charities in France committed to advancing research initiatives.<br />Although aorta atheroma morphology is associated with acute outcomes post-transcatheter aortic valve replacement (TAVR), its association with long-term outcomes post-TAVR remains unknown. This study evaluates the impact of severe aortic atheroma on long-term outcomes following TAVR. We enrolled 977 patients who underwent TAVR between February 2010 and May 2019, with available contrast-enhanced computed tomography data. Severe aortic atheroma was defined as protruding atheroma of ≥3mm thickness with protruding components, ulcerated atheroma with ulcer-like intimal disruption, and atheroma of ≥5mm thickness. The primary endpoint was 2-year major adverse cardiac and cerebrovascular event (MACCE), defined as a composite of cardiovascular death, myocardial infarction, ischemic stroke, and heart failure, events classified as periprocedural (≤30 days), early (30 days to 1 year), and late (>1-year post-TAVR). Patients with severe aortic atheroma (n = 274, 28%) had a higher cumulative incidence of 2-year MACCE than those without (40.6% vs 28.9%, log-rank p = 0.0002), which was attributed to increased risks of ischemic stroke (13.8% vs 6.8%, log-rank p = 0.0012) and cardiovascular death (18.6% vs 10.8%, log-rank p = 0.0009). Severe aortic atheroma was an independent risk factors for 2-year MACCE (adjusted hazard ratio [aHR], 1.49, 95% CI 1.16 to 1.90). In the landmark analysis, severe aortic atheroma was independently associated with periprocedural ischemic stroke and cardiovascular death (aHR, 2.12, 95% CI 1.15 to 3.90 and aHR, 3.29, 95% CI 1.70 to 6.37, respectively), and late ischemic stroke (aHR, 3.71, 95% CI 1.35 to 10.2). Patients with severe aortic atheroma have an increased risk of 2-year MACCE post-TAVR.<br /> (Copyright © 2025 Elsevier Inc. All rights reserved.) |
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| ISSN: | 1879-1913 |
| DOI: | 10.1016/j.amjcard.2025.07.009 |