Age-Related Differences in 1- and 12-Month Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation (from a Large Multicenter Data Repository)

Am J Cardiol. 2016 Oct 1;118(7):1024-30. doi: 10.1016/j.amjcard.2016.07.018. Epub 2016 Jul 28.

Abstract

Scarce data are available on the impact of age on transcatheter aortic valve implantation (TAVI) outcomes. We therefore, analyzed 1,845 consecutive patients from 9 Italian centers who underwent TAVI with the Corevalve Revalving System from September 2007 to March 2014; patients were dichotomized according to their age in the date of the procedure, as follows: 75 to 85 years old and >85 years old. End points were defined according to Valve Academic Research Consortium definitions. In-hospital, 30-day, and 1-year clinical and echocardiographic data were available for 100% of the patients included. Propensity matching was performed. Procedural success rates were high (>94%) and comparable between groups. Although worse baseline renal function was observed in the older group, the incidence of acute kidney injury after procedure was comparable (17.1% and 17.4%, respectively for the 75- to 85- and >85-year-old group, p = 0.877); importantly, >99% of acute kidney injury episodes in both groups were grades 1 and 2. Procedural complications rates were low without between-group differences. In-hospital death (3.7% and 4.6%, p = 0.379) and stroke/transient ischemic attack (1.9% and 1.9%, respectively, p = 0.960) were comparable. The 1-year death rates were 14.9% and 17.2% (p = 0.197) in the 75- to 85- and >85-year-old group, respectively. Cardiovascular death was observed in 7.8% and 7% (p = 0.542), while stroke/transient ischemic attack was demonstrated in 5.2% and 4.4% (p = 0.496), respectively. Results were sustained after propensity matching. In conclusion, advanced age did not negatively impact the outcomes of TAVI through 1-year after procedure.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Kidney Injury / epidemiology*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / epidemiology
  • Aortic Valve Stenosis / surgery*
  • Cause of Death
  • Databases, Factual
  • Echocardiography
  • Female
  • Humans
  • Incidence
  • Ischemic Attack, Transient / epidemiology*
  • Italy / epidemiology
  • Male
  • Mortality*
  • Postoperative Complications / epidemiology*
  • Propensity Score
  • Renal Insufficiency, Chronic / epidemiology
  • Severity of Illness Index
  • Stroke / epidemiology*
  • Transcatheter Aortic Valve Replacement*
  • Treatment Outcome