TY - JOUR
T1 - Temporal Trends in Patient Characteristics and Outcomes of Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement
T2 - A Nationwide Study
AU - Lundahl, Camilla
AU - Kragholm, Kristian
AU - Tayal, Bhupendar
AU - Karasoy, Deniz
AU - Andersen, Niels H
AU - Strange, Jarl E
AU - Olesen, Jonas B
AU - Østergaard, Lauge
AU - Fosbøl, Emil
AU - Torp-Pedersen, Christian
AU - Søgaard, Peter
AU - Terkelsen, Christian J
AU - Nissen, Henrik
AU - De Backer, Ole
AU - Freeman, Phillip M
N1 - Copyright © 2023. Published by Elsevier Inc.
PY - 2024/1
Y1 - 2024/1
N2 - With increased use of transcatheter aortic valve implantation (TAVI) in treatment of aortic stenosis, it is important to evaluate real life data trends in outcomes. This nationwide register-based study aimed to present an outlook on temporal trends in characteristics and outcomes, including mortality. First-time consecutive Danish patients who underwent TAVI from 2010 to 2019 were included in this study. The chi-square and Kruskal–Wallis tests were performed to assess the differences in the characteristics over time and Cochrane–Armitage trend tests were used to examine changes in complications and mortality. Between 2010 and 2019, 4,847 patients (54.6% men, median age 82 [quartile 1 to quartile 3: 77 to 85] years) underwent first-time TAVI. A statistically significant decrease over time was observed for preprocedural hypertension, ischemic heart disease, and heart failure, whereas preexisting chronic obstructive lung disease and preprocedural pacemaker remained stable. We observed a significant decrease in 30- and 90-day postoperative preprocedural pacemaker implantation from 2011 to 2017, with 15.1% and 15.9% in 2011 and 8.6% and 8.9% in 2017, respectively. The incidence of for 30- and 90-day heart failure significantly decreased from 19.3% and 20.3% to 8.5% and 9.1%, respectively. We observed significant changes for 30-day atrial fibrillation, whereas the changes over time for 90-day atrial fibrillation and 30- and 90-day stroke/transient ischemic attack remained insignificant. The all-cause mortality within 30- and 90 days significantly decreased over time from 6.7% and 9.2% in 2011 to 1.5% and 2.7% in 2019 and 2016, respectively. In conclusion, this national study provides general insight on the trends of complications and mortality of TAVI, demonstrating significant reductions over time.
AB - With increased use of transcatheter aortic valve implantation (TAVI) in treatment of aortic stenosis, it is important to evaluate real life data trends in outcomes. This nationwide register-based study aimed to present an outlook on temporal trends in characteristics and outcomes, including mortality. First-time consecutive Danish patients who underwent TAVI from 2010 to 2019 were included in this study. The chi-square and Kruskal–Wallis tests were performed to assess the differences in the characteristics over time and Cochrane–Armitage trend tests were used to examine changes in complications and mortality. Between 2010 and 2019, 4,847 patients (54.6% men, median age 82 [quartile 1 to quartile 3: 77 to 85] years) underwent first-time TAVI. A statistically significant decrease over time was observed for preprocedural hypertension, ischemic heart disease, and heart failure, whereas preexisting chronic obstructive lung disease and preprocedural pacemaker remained stable. We observed a significant decrease in 30- and 90-day postoperative preprocedural pacemaker implantation from 2011 to 2017, with 15.1% and 15.9% in 2011 and 8.6% and 8.9% in 2017, respectively. The incidence of for 30- and 90-day heart failure significantly decreased from 19.3% and 20.3% to 8.5% and 9.1%, respectively. We observed significant changes for 30-day atrial fibrillation, whereas the changes over time for 90-day atrial fibrillation and 30- and 90-day stroke/transient ischemic attack remained insignificant. The all-cause mortality within 30- and 90 days significantly decreased over time from 6.7% and 9.2% in 2011 to 1.5% and 2.7% in 2019 and 2016, respectively. In conclusion, this national study provides general insight on the trends of complications and mortality of TAVI, demonstrating significant reductions over time.
KW - aortic stenosis
KW - epidemiology
KW - mortality
KW - patient outcomes
KW - transcatheter aortic valve implantation
KW - trends
KW - Transcatheter Aortic Valve Replacement
KW - Atrial Fibrillation/surgery
KW - Heart Valve Prosthesis Implantation
KW - Humans
KW - Risk Factors
KW - Male
KW - Treatment Outcome
KW - Postoperative Complications/epidemiology
KW - Aged, 80 and over
KW - Aortic Valve Stenosis/surgery
KW - Aortic Valve/surgery
KW - Female
KW - Heart Failure/surgery
UR - http://www.scopus.com/inward/record.url?scp=85179797922&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2023.11.024
DO - 10.1016/j.amjcard.2023.11.024
M3 - Journal article
C2 - 37984636
SN - 0002-9149
VL - 211
SP - 299
EP - 306
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
ER -