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Mortality and morbidity after transcatheter aortic valve implantation compared to an age- and sex-matched control population: a population-based study from the SWEDEHEART registry

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Název: Mortality and morbidity after transcatheter aortic valve implantation compared to an age- and sex-matched control population: a population-based study from the SWEDEHEART registry
Autoři: Lachonius, Maria, Nielsen, Susanne J., Giang, Kok Wai, Backes, Jenny, Bjursten, Henrik, Hagström, Henrik, James, Stefan, Settergren, Magnus, Skoglund, Kristofer, Jeppsson, Anders, Pétursson, Pétur
Přispěvatelé: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Thoracic Surgery, Less invasive cardiac surgery, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Thoraxkirurgi, Skonsammare hjärtkirurgi, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Thoracic Surgery, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Thoraxkirurgi, Originator
Zdroj: European Heart Journal - Quality of Care and Clinical Outcomes. 11(5):614-621
Témata: Medical and Health Sciences, Clinical Medicine, Cardiology and Cardiovascular Disease, Medicin och hälsovetenskap, Klinisk medicin, Kardiologi och kardiovaskulära sjukdomar, Surgery, Kirurgi
Popis: Introduction Data are lacking about the risk for death and major adverse cardiovascular events (MACE) after transcatheter aortic valve implantation (TAVI), compared to the general population. Therefore, we assessed the risk for all-cause death and MACE after TAVI in patients aged 65 years and older, in comparison to an age- and sex-matched control population. Methods and results In total, 5924 TAVI patients and 10 928 matched controls [mean age 82.1, standard deviation (SD) 6.0, and 81.9, SD 6.1, respectively] were included from 2014 to 2020. The SWEDEHEART registry and four mandatory national registers were used to collect data. Cox regression models were used to assess the association with all-cause mortality and MACE risk. In total, 1410 (23.8%) of the TAVI patients and 2115 (19.4%) controls died during the follow-up period. Median follow-up was 1.9 years (inter quartile range 0.9–3.3) respectively. The crude mortality and MACE risks were higher in TAVI patients than in controls {hazard ratios 1.27 [95% Confidence interval (CI): 1.19–1.36] and HR 1.44 (95% CI: 1.35–1.53), respectively}. After adjustment, there was a lower risk for both mortality and MACE in TAVI patients [adjusted hazard ratio (aHR) 0.77 (95% CI: 0.71–0.84) and aHR 0.90 (95% CI: 0.83–0.98), respectively]. Conclusion After adjustments for comorbidities, the mortality risk was lower in TAVI patients, compared with an age- and sex-matched control population. These findings suggest that the high burden of comorbidities in TAVI patients has a strong impact on the risk for mortality and MACE after TAVI.
Přístupová URL adresa: https://doi.org/10.1093/ehjqcco/qcaf008
Databáze: SwePub
Popis
Abstrakt:Introduction Data are lacking about the risk for death and major adverse cardiovascular events (MACE) after transcatheter aortic valve implantation (TAVI), compared to the general population. Therefore, we assessed the risk for all-cause death and MACE after TAVI in patients aged 65 years and older, in comparison to an age- and sex-matched control population. Methods and results In total, 5924 TAVI patients and 10 928 matched controls [mean age 82.1, standard deviation (SD) 6.0, and 81.9, SD 6.1, respectively] were included from 2014 to 2020. The SWEDEHEART registry and four mandatory national registers were used to collect data. Cox regression models were used to assess the association with all-cause mortality and MACE risk. In total, 1410 (23.8%) of the TAVI patients and 2115 (19.4%) controls died during the follow-up period. Median follow-up was 1.9 years (inter quartile range 0.9–3.3) respectively. The crude mortality and MACE risks were higher in TAVI patients than in controls {hazard ratios 1.27 [95% Confidence interval (CI): 1.19–1.36] and HR 1.44 (95% CI: 1.35–1.53), respectively}. After adjustment, there was a lower risk for both mortality and MACE in TAVI patients [adjusted hazard ratio (aHR) 0.77 (95% CI: 0.71–0.84) and aHR 0.90 (95% CI: 0.83–0.98), respectively]. Conclusion After adjustments for comorbidities, the mortality risk was lower in TAVI patients, compared with an age- and sex-matched control population. These findings suggest that the high burden of comorbidities in TAVI patients has a strong impact on the risk for mortality and MACE after TAVI.
ISSN:20585225
20581742
DOI:10.1093/ehjqcco/qcaf008