Valvular & structural heart diseaseCohort study
Trends in Transcatheter Aortic Valve Replacement Outcomes
- Retrospective cohort study
- registry-based
- national
- 786 US hospitals
Authors' conclusion
In this observational cohort study performing a national analysis of outcomes after TAVR, it was found that risk-adjusted 30-day mortality increased modestly from January 2019 to March 2022. However, no site-level, patient-related, or process-related factors were identified that could explain these findings.
Study context
- Population
- Patients with severe AS treated with transcatheter aortic valve replacement (TAVR) at 786 US hospitals, Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapies (TVT) Registry, January 2019–March 2022
- Participants
- 210,495 patients
- Exposure
- Trend over time, 2019–2022
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Main finding
As reported in the abstract
30-day mortality, trend over time (OR per year) · Q1 2019 to Q1 2022
Odds ratio, per year (95% CI)
unadjustedunadjusted OR for time
0.98(0.94–1.01)
adjusting for patient characteristicsOR for time
1.05(1.02–1.08)
adjusting for procedural characteristicsOR for time, further adjusted
1.09(1.05–1.13)
Per year, as printed
- Unadjusted 30-day mortality, Q1 2019
- 2.4%
- Unadjusted 30-day mortality, end of Q1 2022
- 2.2%
- No significant change in unadjusted 30-day mortality
- P for trend = 0.10
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| Adjusted odds of death per year, exploratory exclusion analyses — excluding sites that entered the STS/ACC TVT Registry in 2019 or later · exploratory analyses | 1.09 (1.05–1.13) | |
| Adjusted odds of death per year, exploratory exclusion analyses — low-volume sites · excluded · exploratory analyses | 1.09 (1.06–1.13) | |
| Adjusted odds of death per year, exploratory exclusion analyses — low-risk patients · excluded · exploratory analyses | 1.11 (1.07–1.15) | |
| Adjusted odds of death per year, exploratory exclusion analyses — patients with a bicuspid aortic valve · excluded · exploratory analyses | 1.09 (1.05–1.13) | |
| Adjusted odds of death per year, exploratory exclusion analyses — in-hospital deaths · excluded · exploratory analyses | 1.08 (1.03–1.14) | |
| Adjusted odds of death per year, exploratory exclusion analyses — patients who experienced a major vascular complication · excluded · exploratory analyses | 1.09 (1.05–1.12) | |
| 0.512Odds ratio (log scale) |
Adjusted odds of death per year, exploratory exclusion analyses
- No meaningful changes in adjusted odds of death
Original publication
Trends in Transcatheter Aortic Valve Replacement Outcomes. JAMA Cardiol. Published 1 December 2024. doi:10.1001/jamacardio.2024.3453
Summarised from the published abstract; every number is checked against it