Valvular & structural heart diseaseCohort study
Potentially futile outcome after uncomplicated transcatheter aortic valve implantation (TAVI): Insights from the transfusion requirements in transcatheter aortic valve implantation (TRITAVI) registry
- international, investigator-initiated registry
- 18 European sites
Authors' conclusion
Risk of death between 30 days and 1 year after noncomplicated TAVI is not negligible even for patients without major peri-procedural complications. It appears mainly driven by non-CV reasons and predicted by baseline renal function, baseline LVEF, and atrial fibrillation.
Study context
- Population
- Patients with symptomatic severe aortic stenosis undergoing TAVIpatients included
- Participants
- 11,246 patients
- Outcome
- All-cause death between 30 days and 1 year without major peri-procedural complications (major vascular complications, stage 2 to 3 acute kidney injury (AKI) and transfusions)
- Follow-up
- Between 30 days and 1 year
Main finding
As reported in the abstract
Died between 1 and 12 months without major peri-procedural complications
454 (4%)
Of these, died for cardiovascular reasons
78 (0.7%)
Of these, died for noncardiovascular reasons
376 (3.3%)
Observational data: associations, not effects.
Further findings
Predictors of the primary end point
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| COPD | 1.35 (1.05–1.73) | P = 0.002 | |
| Atrial Fibrillation | 1.46 (1.16–1.84) | P = 0.001 | |
| severe Chronic Kidney Disease (CKD) | 1.70 (1.10–2.62) | P = 0.018 | |
| moderate reduction of LVEF | 1.42 (1.07–1.90) | P = 0.017 | |
| severe reduction of LVEF | 1.62 (1.17–2.23) | P = 0.003 | |
| 0.20.5125Hazard ratio (log scale) |
Predictors of non-CV death
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| baseline creatinine · increased risk | 1.2 (1.1–1.4) | P = 0.002 | |
| AF · increased risk | 1.4 (1.1–1.8) | P = 0.008 | |
| higher baseline LVEF · lower risk | 0.9 (0.8–0.99) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Competing risk analysis: non-CV vs CV death
- Risk of non-CV death appeared more relevant and steadily increased across the year, while risk of CV death was lower
Original publication
Summarised from the published abstract; every number is checked against it