Valvular & structural heart diseaseCohort study
Prognostic value of early haemodynamic valve deterioration after transcatheter aortic valve implantation (TAVI)
- international, multicentre registry
- consecutive patients
- 16 centres
Authors' conclusion
Early HVD was observed in 3.1% of patients and was associated with adverse clinical and haemodynamic outcomes after TAVI. These findings validate the clinical relevance of detecting early HVD and the necessity for further research to guide optimal management of these patients.
Study context
- Population
- Consecutive patients undergoing TAVIpatients analysed, early haemodynamic valve deterioration (HVD) in 231 (3.1%)
- Participants
- 7,392 patients
- Exposure
- Early HVD and its association with clinical and haemodynamic outcomes after TAVI
- early HVDn = 231
- Outcome
- Valve-related long-term clinical efficacy according to the Valve Academic Research Consortium 3
- Follow-up
- Median 4 years (interquartile range 2-5)
Main finding
As reported in the abstract
Subdistribution hazard ratio
0.42
95% CI 0.32–0.56
Observational data: associations, not effects.
Further findings
Stroke · median follow-up of 4 years
| Comparison | sHR (95% CI) | |
|---|---|---|
| early HVD · higher risk with early HVD | 2.32 (1.51–3.57) | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
Stage 2 or 3 bioprosthetic valve dysfunction · median follow-up of 4 years
| Comparison | sHR (95% CI) | |
|---|---|---|
| early HVD · higher risk with early HVD | 2.74 (2.10–3.57) | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
Stage 3 bioprosthetic valve dysfunction · median follow-up of 4 years
| Comparison | sHR (95% CI) | |
|---|---|---|
| early HVD · higher risk with early HVD | 3.53 (2.15–5.79) | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
Bioprosthetic valve failure · median follow-up of 4 years
| Comparison | sHR (95% CI) | |
|---|---|---|
| early HVD · higher risk with early HVD | 3.04 (2.06–4.52) | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
Independent predictors of early HVD
| Comparison | Estimate | |
|---|---|---|
| Body mass index | aOR per 5 kg/m² increase 1.15 (95% CI 1.02–1.30) | |
| prosthesis size <26 mm | aOR 1.96 (95% CI 1.43–2.70) | |
| valve-in-valve procedure | aOR 2.76 (95% CI 1.83–4.08) | |
| absence of anticoagulation at discharge | aOR 1.64 (95% CI 1.22–2.22) | |
| 0.20.5125Ratio (log scale) |
| Outcome | Values | Estimate |
|---|---|---|
| Incidence of early HVD · within the first three months after TAVI | early HVD 3.1% |
Original publication
Summarised from the published abstract; every number is checked against it