Valvular & structural heart disease

Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement

JACC Cardiovasc IntervPublished Retrospective cohort study

Authors' conclusion

The extent of extra-aortic valve cardiac damage before and after TAVR and changes in cardiac stage early after TAVR have important prognostic implications during long-term follow-up.

Study context

Population
Patients undergoing transfemoral transcatheter aortic valve replacement (TAVR), January 2007–June 2022
Participants
1,863 patients
Exposure
Cardiac damage stages 0–4 before and after TAVR
  • Stage 0n = 56reference
  • Stage 1n = 225
  • Stage 2n = 729
  • Stage 3n = 388
  • Stage 4n = 465
Outcome
All-cause mortality by cardiac damage stage
Follow-up
5 years
Methodological detailssingle-centre, registry-based
  • Single-centre
  • Registry-based

Main finding

As reported in the abstract

Five-year all-cause mortality
For linear trend
Each group vs stage 0HRadjusted (95% CI)P value
Cardiac damage at baseline
1.34(1.24–1.44)
P < 0.001
Cardiac damage after TAVR
1.40(1.30–1.51)
P < 0.001

Observational data: associations, not effects.

Further findings

Change in cardiac stage early after TAVR

Cardiac stage changed
47.7%
Improved (stages 1-4)
30.1%
Deteriorated (stages 0-3)
24.7%

5-year all-cause mortality by change in cardiac damage (improved, unchanged, worsened)

Stage 2: mortality stratified by change
log-rank P < 0.001
Stage 3: mortality stratified by change
log-rank P = 0.005
Stage 4: mortality stratified by change
log-rank P <0.001

Original publication

Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. Published 22 April 2024. doi:10.1016/j.jcin.2024.02.011

Summarised from the published abstract; every number is checked against it

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