TY - JOUR
T1 - Age-Related 2-Year Mortality After Transcatheter Aortic Valve Replacement: the YOUNG TAVR Registry
AU - Navarese, Eliano P.
AU - Andreotti, Felicita
AU - Kołodziejczak, Michalina
AU - Wanha, Wojciech
AU - Lauten, Alexander
AU - Veulemans, Verena
AU - Frediani, Lara
AU - Kubica, J.
AU - De Cillis, Emanuela
AU - Wojakowski, Wojciech
AU - Ochala, Andrzej
AU - Zeus, Tobias
AU - Bortone, Alessandro
AU - Buffon, Antonino Maria Tommaso
AU - Jung, Christian
AU - Pestrichella, Vincenzo
AU - Gurbel, Paul A.
PY - 2019
Y1 - 2019
N2 - Objective: To comparatively assess the natural history of patients of different ages undergoing transcatheter aortic valve replacement (TAVR). Patients and Methods: For this study, we used the YOUNG TAVR, an international, multicenter registry investigating mortality trends up to 2 years in patients with aortic valve stenosis treated by TAVR, classified according to 3 prespecified age groups: 75 years or younger (n=179), 76 to 86 years (n=602), and older than 86 years (n=221). A total of 1002 patients undergoing TAVR were included. Demographic, clinical, and outcome data in the youngest group were compared with those of patients 76 to 86 years and older than 86 years. Patients were followed up for up to 2 years. Results: Compared with patients 75 years or younger (reference group), patients aged 76 to 86 years and older than 86 years had nonsignificantly different 30-day mortality (odds ratio, 0.76; 95% CI, 0.41-1.38; P=.37 and odds ratio, 1.27; 95% CI, 0.62-2.60; P=.51, respectively) and 1-year mortality (hazard ratio (HR), 0.72; 95% CI, 0.48-1.09; P=.12 and HR, 1.11; 95% CI, 0.88-1.40; P=.34, respectively). Mortality at 2 years was significantly lower among patients aged 76 to 86 years (HR, 0.62; 95% CI, 0.42-0.90; P=.01) but not among the older group (HR, 1.06; 95% CI, 0.68-1.67; P=.79). The Society of Thoracic Surgeons 30-day mortality score was lower in younger patients who, however, had a significantly higher prevalence of chronic obstructive pulmonary disease (P=.005 vs the intermediate group and P=.02 vs the older group) and bicuspid aortic valves (P=.02 vs both older groups), larger left ventricles, and lower ejection fractions. Conclusion: In the present registry, mortality at 2 years after TAVR among patients 75 years or younger was higher compared with that of patients aged 75 to 86 years and was not markedly different from that of patients older than 86 years. The findings are attributable at least in part to a greater burden of comorbidities in the younger age group that are not entirely captured by current risk assessment tools.
AB - Objective: To comparatively assess the natural history of patients of different ages undergoing transcatheter aortic valve replacement (TAVR). Patients and Methods: For this study, we used the YOUNG TAVR, an international, multicenter registry investigating mortality trends up to 2 years in patients with aortic valve stenosis treated by TAVR, classified according to 3 prespecified age groups: 75 years or younger (n=179), 76 to 86 years (n=602), and older than 86 years (n=221). A total of 1002 patients undergoing TAVR were included. Demographic, clinical, and outcome data in the youngest group were compared with those of patients 76 to 86 years and older than 86 years. Patients were followed up for up to 2 years. Results: Compared with patients 75 years or younger (reference group), patients aged 76 to 86 years and older than 86 years had nonsignificantly different 30-day mortality (odds ratio, 0.76; 95% CI, 0.41-1.38; P=.37 and odds ratio, 1.27; 95% CI, 0.62-2.60; P=.51, respectively) and 1-year mortality (hazard ratio (HR), 0.72; 95% CI, 0.48-1.09; P=.12 and HR, 1.11; 95% CI, 0.88-1.40; P=.34, respectively). Mortality at 2 years was significantly lower among patients aged 76 to 86 years (HR, 0.62; 95% CI, 0.42-0.90; P=.01) but not among the older group (HR, 1.06; 95% CI, 0.68-1.67; P=.79). The Society of Thoracic Surgeons 30-day mortality score was lower in younger patients who, however, had a significantly higher prevalence of chronic obstructive pulmonary disease (P=.005 vs the intermediate group and P=.02 vs the older group) and bicuspid aortic valves (P=.02 vs both older groups), larger left ventricles, and lower ejection fractions. Conclusion: In the present registry, mortality at 2 years after TAVR among patients 75 years or younger was higher compared with that of patients aged 75 to 86 years and was not markedly different from that of patients older than 86 years. The findings are attributable at least in part to a greater burden of comorbidities in the younger age group that are not entirely captured by current risk assessment tools.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve Stenosis
KW - Comorbidity
KW - Europe
KW - Female
KW - Follow-Up Studies
KW - Geriatric Assessment
KW - Humans
KW - Internationality
KW - Kaplan-Meier Estimate
KW - Male
KW - Mortality
KW - Prevalence
KW - Proportional Hazards Models
KW - Pulmonary Disease, Chronic Obstructive
KW - Registries
KW - Risk Assessment
KW - Survival Analysis
KW - Time Factors
KW - Transcatheter Aortic Valve Replacement
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve Stenosis
KW - Comorbidity
KW - Europe
KW - Female
KW - Follow-Up Studies
KW - Geriatric Assessment
KW - Humans
KW - Internationality
KW - Kaplan-Meier Estimate
KW - Male
KW - Mortality
KW - Prevalence
KW - Proportional Hazards Models
KW - Pulmonary Disease, Chronic Obstructive
KW - Registries
KW - Risk Assessment
KW - Survival Analysis
KW - Time Factors
KW - Transcatheter Aortic Valve Replacement
UR - http://hdl.handle.net/10807/170692
U2 - 10.1016/j.mayocp.2019.01.008
DO - 10.1016/j.mayocp.2019.01.008
M3 - Article
SN - 0025-6196
VL - 94
SP - 1457
EP - 1466
JO - Mayo Clinic Proceedings
JF - Mayo Clinic Proceedings
ER -