Valvular & structural heart diseaseCohort study
Long-Term Outcomes After Transcatheter Aortic Valve Replacement in Nonagenarians
- multicenter Japanese registry
- transfemoral transcatheter aortic valve replacement (TAVR)
- 5-year follow-up
Authors' conclusion
In this large multicenter registry, excess mortality in nonagenarians after TAVR was driven mainly by noncardiovascular causes. Frailty and malnutrition, rather than chronological age, were central determinants of long-term outcomes. These findings emphasize that TAVR candidacy in nonagenarians should be guided on geriatric assessment of frailty and nutrition to identify patients most likely to achieve meaningful survival while avoiding futile interventions.
Study context
- Population
- Patients who underwent transfemoral TAVR in a multicenter Japanese registry, including nonagenarianspatients who underwent transfemoral TAVR, 700 aged ≥90 years · aged ≥90 years 700
- Participants
- 4,623 patients
- Exposure
- patients aged ≥90 years than in those <90 years
- aged ≥90 yearsn = 700
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Noncardiovascular mortality (such as senility and infections) · 5 years
P < 0.001
Cardiovascular mortality · 5 years · similar
P = 0.198
Predictors of mortality (multivariable analysis)
- age ≥90 years was not an independent predictor; frailty and malnutrition were the strongest prognostic factors
Clinical Frailty Scale-Geriatric Nutritional Risk Index heatmap
- marked heterogeneity, identifying subgroups of nonagenarians with preserved nutrition and low frailty who achieved favorable long-term survival
Original publication
Summarised from the published abstract; every number is checked against it