Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities
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...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722002068 |
| _version_ | 1811201551356657664 |
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| author | Jarl E. Strange Emil L. Fosbøl Caroline Sindet-Pedersen Eva Havers-Borgersen Lars Køber Gunnar H. Gislason Jonas B. Olesen |
| author_facet | Jarl E. Strange Emil L. Fosbøl Caroline Sindet-Pedersen Eva Havers-Borgersen Lars Køber Gunnar H. Gislason Jonas B. Olesen |
| author_sort | Jarl E. Strange |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T02:23:21Z |
| format | Article |
| id | doaj.art-8727b526a190439685d210de91adec60 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-12T02:23:21Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-8727b526a190439685d210de91adec602022-12-22T03:52:04ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-12-0143101157Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbiditiesJarl E. Strange0Emil L. Fosbøl1Caroline Sindet-Pedersen2Eva Havers-Borgersen3Lars Køber4Gunnar H. Gislason5Jonas B. Olesen6Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Corresponding author at: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte Hospital, Post 635, Gentofte Hospitalsvej 8, 2900 Hellerup, Denmark.Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; The Danish Heart Foundation, Copenhagen, DenmarkDepartment of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; The Danish Heart Foundation, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, DenmarkBackground: 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.http://www.sciencedirect.com/science/article/pii/S2352906722002068Transcatheter aortic valve replacementMortalityComorbiditiesAgePrognosis |
| spellingShingle | Jarl E. Strange Emil L. Fosbøl Caroline Sindet-Pedersen Eva Havers-Borgersen Lars Køber Gunnar H. Gislason Jonas B. Olesen Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities International Journal of Cardiology: Heart & Vasculature Transcatheter aortic valve replacement Mortality Comorbidities Age Prognosis |
| title | Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities |
| title_full | Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities |
| title_fullStr | Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities |
| title_full_unstemmed | Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities |
| title_short | Mortality at one year after transcatheter aortic valve replacement – Relation of age and comorbidities |
| title_sort | mortality at one year after transcatheter aortic valve replacement relation of age and comorbidities |
| topic | Transcatheter aortic valve replacement Mortality Comorbidities Age Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722002068 |
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