Acute cardiac care & resuscitation
Transcatheter vs. surgical aortic valve replacement in patients with aortic stenosis and cardiogenic shock
Authors' conclusion
This nationwide observational analysis showed that TAVR is increasingly performed in patients with AS-CS and is associated with similar rates of in-hospital mortality and 90-day readmissions but lower rates of in-hospital complications and resource utilization compared with SAVR.
Study context
- Population
- Patients hospitalized for aortic stenosis (AS) with cardiogenic shock, Nationwide Readmission Database (2016–21)
- Participants
- 16,161 patients
- Exposure
- Transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR)
- TAVRn = 6,470
- SAVRn = 9,691reference
- Outcome
- In-hospital outcomes
Methodological detailsnationwide, multivariable regression, propensity-matching analyses
- Nationwide
- Multivariable regression
- Propensity-matching analyses
Main finding
As reported in the abstract
TAVR vs SAVRAdjusted odds ratio (95% CI)
Stroke
0.63(0.47–0.84)
AKI
0.80(0.69–0.93)
Observational data: associations, not effects.
Further findings
90-day all-cause and HF readmissions
- Similar rates between TAVR and SAVR
Resource utilization
- Shorter length of stay, lower total costs and fewer non-home discharges with TAVR
Proportion of TAVR in AS-CS, 2016 to 2021
- TAVR proportion increased from 29.5 to 46.5%
- P for trend < 0.01
Safety
| Outcome | aOR (95% CI) | |
|---|---|---|
| Major bleeding | 0.54 (0.40–0.71) | |
| Vascular complications | 1.56 (1.23–1.97) | |
| 0.512Adjusted odds ratio (log scale) |
Original publication
Transcatheter vs. surgical aortic valve replacement in patients with aortic stenosis and cardiogenic shock. Eur Heart J Acute Cardiovasc Care. Published 12 September 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →