Outcomes After Transcatheter Aortic Valve Implantation in Patients Excluded From Clinical Trials

doi:10.1016/j.jacadv.2023.100271

Valvular & structural heart disease

Outcomes After Transcatheter Aortic Valve Implantation in Patients Excluded From Clinical Trials

JACC AdvPublished 31 Mar 2023Retrospective cohort study

Main finding · Net adverse clinical eventsResultAdjusted odds ratio 1.83 95% CI 1.73–1.95

Read the original article ↗PubMed

Cite

Authors' conclusion

Patients undergoing CTE-TAVI have a higher likelihood of mortality, stroke, and bleeding than those undergoing CTI-TAVI.

Study context

Population: Patients undergoing Transcatheter Aortic Valve Implantation (TAVI), US National Readmission Database, 2015–2019
Participants: 223,238 patients

Exposure: TAVI in clinical-trial-excluded vs clinical-trial-included patients
CTE-TAVIn = 41,408
Outcome: Net adverse clinical events:
Mortality
Stroke
Major bleeding
Follow-up: Index admission

Methodological detailspropensity-score matched

Propensity-score matched

Main finding

Net adverse clinical events

Adjusted odds ratio

1.83

95% CI 1.73–1.95

CTE-TAVIvs CTI-TAVI

aOR 1.83 (95% CI 1.73–1.95)

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcome	← Lower odds with CTE-TAVI ←→ Higher odds with CTE-TAVI →	aOR (95% CI)
Components: mortality, stroke, major bleeding · index admissionMortality	0.20.5125	2.94 (2.66–3.24)
Components: mortality, stroke, major bleeding · index admissionStroke	0.20.5125	1.20 (1.07–1.34)
Components: mortality, stroke, major bleeding · index admissionMajor bleeding	0.20.5125	1.49 (1.36–1.63)
	0.20.5125Adjusted odds ratio (log scale)

CTE-TAVI utilization trend · 2015-2019: 18.5% · 41,408
CTE-TAVI utilization trend — Steep yearly increase in CTE-TAVI utilization: P = 0.026

Outcomes by individual contraindication (subgroups) · 30 and 180 days

Bicuspid aortic valve, leukopenia, peptic ulcer disease: similar outcomes vs clinical trials included TAVI (CTI-TAVI)
End-stage renal disease, bioprosthetic aortic valves, coagulopathy: higher readmission rate at 30 and 180 days

Original publication

Outcomes After Transcatheter Aortic Valve Implantation in Patients Excluded From Clinical Trials. JACC Adv. Published 31 March 2023. doi:10.1016/j.jacadv.2023.100271

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →