Age-Related 2-Year Mortality After Transcatheter Aortic Valve Replacement: the YOUNG TAVR Registry

Felicita Andreotti, Antonino Buffon, Eliano P. Navarese, Michalina Kołodziejczak, Wojciech Wanha, Alexander Lauten, Verena Veulemans, Lara Frediani, J. Kubica, Emanuela De Cillis, Wojciech Wojakowski, Andrzej Ochala, Tobias Zeus, Alessandro Bortone, Christian Jung, Vincenzo Pestrichella, Paul A. Gurbel

Risultato della ricerca: Contributo in rivistaArticolo in rivista

9 Citazioni (Scopus)

Abstract

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.
Lingua originaleEnglish
pagine (da-a)1457-1466
Numero di pagine10
RivistaMayo Clinic Proceedings
Volume94
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis
  • Comorbidity
  • Europe
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Humans
  • Internationality
  • Kaplan-Meier Estimate
  • Male
  • Mortality
  • Prevalence
  • Proportional Hazards Models
  • Pulmonary Disease, Chronic Obstructive
  • Registries
  • Risk Assessment
  • Survival Analysis
  • Time Factors
  • Transcatheter Aortic Valve Replacement

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