Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities

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Background: Of patients undergoing transcatheter aortic valve replacement (TAVR), 80–90 % are at extreme, high, or intermediate risk. Patient selection considering futile outcomes in these groups is difficult as significant comorbidity burden is common. Thus, we examined 1-year mortality after TAVR according to age and comorbidities. Methods: Between 2008 and 2021 all Danish TAVR-patients were included. From a multivariate Cox-regression model, significant characteristics associated with 1-year all-cause mortality were identified. The study population was divided into four groups according to number of significant comorbidities present at baseline: Low (0 comorbidities), mild (1 comorbidity), moderate (2 comorbidities), and high (3 or more comorbidities). The 1-year risk of all-cause mortality with 95 % confidence intervals (CI) was estimated by each group. Results: In total, 7,104 patients underwent TAVR. Significant covariates associated with 1-year all-cause mortality were chronic kidney disease, heart failure, chronic obstructive pulmonary disease, peripheral artery disease, and age ≥ 85 years. The four baseline groups comprised low (n = 2,666), mild (n = 2,814), moderate (n = 1,246), and high comorbidity burden (n = 378). The 1-year risk of all-cause mortality was 5.5 % (95 %CI: 4.6–6.4 %) in the low baseline comorbidity burden group. Conversely, the 1-year risk of all-cause mortality was 25.0 % (95 %CI: 20.4–29.3 %) in the high baseline burden group. Conclusions: In a national sample of TAVR patients, readily available information on age and comorbidities, can be used to identify a high-risk group with 25 % 1-year mortality. This provides physicians and patients with an easy-to-understand view on 1-year prognosis after TAVR and may complement patient selection for improved long-term outcomes.

OriginalsprogEngelsk
Artikelnummer101157
TidsskriftIJC Heart and Vasculature
Vol/bind43
ISSN2352-9067
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This work was supported by “Torben og Alice Frimodts Fond, Denmark”; “Dagmar Marshalls Fond, Denmark”; “Eva og Henry Frænkels Mindefond, Denmark”; and “Snedkermester Sophus Jacobsen og Hustru Astrid Jacobsens Fond, Denmark”. None of the funders had any influence on the design and conduct of the study, in the collection, analysis, and interpretation of the data, and in the preparation, review, or approval of the manuscript.

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© 2022 The Authors

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