Valvular & structural heart diseaseCohort study
Long-Term Impact of Cardiac Damage Following Transcatheter Aortic Valve Replacement
- Retrospective cohort study
- single-centre
- registry-based
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
Main finding
As reported in the abstract
Five-year all-cause mortality
- Cardiac damage at baseline
- HRadjusted 1.34 (95% CI 1.24–1.44); P < 0.001
- Cardiac damage after TAVR
- HRadjusted 1.40 (95% CI 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