Short- and Long-Term Mortality and Stroke Risk After Transcatheter Aortic Valve Implantation
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Short- and Long-Term Mortality and Stroke Risk After Transcatheter Aortic Valve Implantation. / Jakobsen, Lars; Terkelsen, Christian J; Søndergaard, Lars; De Backer, Ole; Aarøe, Jens; Nissen, Henrik; Johnsen, Søren P; Christiansen, Evald H.
I: The American Journal of Cardiology, Bind 121, Nr. 1, 2018, s. 78-85.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Short- and Long-Term Mortality and Stroke Risk After Transcatheter Aortic Valve Implantation
AU - Jakobsen, Lars
AU - Terkelsen, Christian J
AU - Søndergaard, Lars
AU - De Backer, Ole
AU - Aarøe, Jens
AU - Nissen, Henrik
AU - Johnsen, Søren P
AU - Christiansen, Evald H
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - No published studies have compared the outcome after transcatheter aortic valve implantation (TAVI) with the outcome in the general population. Thus, it is unknown whether TAVI restores normal life expectancy and stroke risk. Furthermore, despite the increasing use of TAVI, only little is known about the temporal trends for TAVI regarding patient characteristics and outcomes. We identified all Danish patients treated with TAVI from 2006 to 2014 (n = 1,631) and 9,737 general population controls matched by gender, age, and co-morbidity. The primary end point was a composite end point of all-cause mortality and stroke. During the first 90 days, the risk of the combined end point, the stroke risk, and mortality were significantly higher among TAVI patients compared with controls (9.4%, 7.5%, and 2.5%, respectively, in TAVI patients compared with 2.0%, 1.6%, and 0.5% in controls). After 90 days, there were no differences (adjusted mortality rate ratio, stroke rate ratio, and mortality or stroke rate ratio 0.92 [0.79 to 1.06], 1.32 [0.98 to 1.78], and 1.00 [0.90 to 1.10], respectively). During the study period, there were small changes in the characteristics of patients treated with TAVI; however, more patients were treated by transfemoral access; fewer needed blood transfusions, hospital stays were shorter, and the overall mortality rate decreased. In conclusion, 90 days after TAVI, the stroke risk and mortality of the TAVI patients were comparable with the stroke risk and mortality of the general population. Over time, the patient risk profiles have remained largely unchanged; however, outcomes have improved substantially, including lower short- and long-term mortality.
AB - No published studies have compared the outcome after transcatheter aortic valve implantation (TAVI) with the outcome in the general population. Thus, it is unknown whether TAVI restores normal life expectancy and stroke risk. Furthermore, despite the increasing use of TAVI, only little is known about the temporal trends for TAVI regarding patient characteristics and outcomes. We identified all Danish patients treated with TAVI from 2006 to 2014 (n = 1,631) and 9,737 general population controls matched by gender, age, and co-morbidity. The primary end point was a composite end point of all-cause mortality and stroke. During the first 90 days, the risk of the combined end point, the stroke risk, and mortality were significantly higher among TAVI patients compared with controls (9.4%, 7.5%, and 2.5%, respectively, in TAVI patients compared with 2.0%, 1.6%, and 0.5% in controls). After 90 days, there were no differences (adjusted mortality rate ratio, stroke rate ratio, and mortality or stroke rate ratio 0.92 [0.79 to 1.06], 1.32 [0.98 to 1.78], and 1.00 [0.90 to 1.10], respectively). During the study period, there were small changes in the characteristics of patients treated with TAVI; however, more patients were treated by transfemoral access; fewer needed blood transfusions, hospital stays were shorter, and the overall mortality rate decreased. In conclusion, 90 days after TAVI, the stroke risk and mortality of the TAVI patients were comparable with the stroke risk and mortality of the general population. Over time, the patient risk profiles have remained largely unchanged; however, outcomes have improved substantially, including lower short- and long-term mortality.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve Stenosis/mortality
KW - Case-Control Studies
KW - Denmark/epidemiology
KW - Female
KW - Humans
KW - Male
KW - Postoperative Complications/epidemiology
KW - Risk Factors
KW - Stroke/epidemiology
KW - Survival Rate
KW - Transcatheter Aortic Valve Replacement/adverse effects
U2 - 10.1016/j.amjcard.2017.09.014
DO - 10.1016/j.amjcard.2017.09.014
M3 - Journal article
C2 - 29103605
VL - 121
SP - 78
EP - 85
JO - Am. J. Cardiol.
JF - Am. J. Cardiol.
SN - 0002-9149
IS - 1
ER -
ID: 213326900