Valvular & structural heart disease
‘Incidence and impact of structural valve deterioration following transcatheter aortic valve implantation (TAVI): a multicenter real-world study’
Authors' conclusion
In this real-world registry, the incidence of SVD at 8 years after TAVI was relatively low. The risk of SVD was higher among BE compared with SE valve recipients. SVD was associated with an increased risk of heart failure rehospitalization and a trend towards a higher risk of cardiovascular death.
Study context
- Population
- Patients who underwent TAVI (2007–2020)After inverse probability treatment weighting (IPTW), 1848 patients were selected
- Participants
- 2,040 patients
- Exposure
- Compare the incidence of structural valve deterioration (SVD) between balloon-expandable (BE) and self-expandable (SE) valves
- BEn = 973
- SEn = 875reference
- Outcome
- SVD and BVF, overall cohort (estimated incidence)
- Follow-up
- 8 years
Methodological detailsinverse probability treatment weighting (IPTW), 9 centres, registry
- Inverse probability treatment weighting (IPTW)
- 9 centres
- Registry
Main finding
As reported in the abstract
SVD
13.3% [95% confidence interval (CI) 9.8-18%]
Bioprosthetic valve failure (BVF)
11.5%
95% CI 8.9–14.8%
Observational data: associations, not effects.
Further findings
| Outcome | BE | SE | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| SVD · median follow-up of 4 yearsAfter IPTW | 5.25% | 1.19% | 10.25 (3.79–27.71) | P < 0.001 | |
| All-cause BVF · median follow-up of 4 yearsAfter IPTW | 6.41% | 3.2% | 2.1 (1.27–3.47) | P = 0.004 | |
| 0.050.21520Hazard ratio (log scale) |
Cardiovascular death and heart failure rehospitalization in patients developing SVD
- Trend towards a higher incidence of cardiovascular death
- P = 0.06
- Significantly higher risk of heart failure rehospitalization
- P = 0.048
Combined endpoint of cardiovascular death, heart failure rehospitalization and valve reintervention
- No differences between BE and SE recipients
- P = 0.46
- After IPTW
Original publication
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