Abstract
To investigate the long-term outcomes of patients with severe comorbidities (sCM) undergoing transcatheter aortic valve replacement (TAVR). The benefit of TAVR may be limited among patients with sCM due to a lack of mortality- or quality-of-life-benefit. All TAVR patients in the Allina Health System between January 1, 2011 and August 7, 2018 were included (n = 890, 82 ± 8 years, 55% men). sCM included: severe lung disease, severe liver disease, end-stage renal disease, severe, severe dementia, severe dilated cardiomyopathy, and frailty. Outcomes between patients with (n = 215, 24%) and without (n = 675, 76%) sCM were compared. At baseline, patients with sCM had worse symptoms, higher STS-PROM and a lower Kansas City Cardiomyopathy Questionnaire (KCCQ) score compared to those without. During a median follow-up of 15 months (IQR, 7-29 months), there were 208 (23%) deaths. Patients with sCM had a lower 3-year survival free from all-cause mortality (40% vs. 79%, p < .001), and lower 3-year survival free from the composite endpoint of all-cause mortality, re-hospitalization for heart failure, myocardial infarction or stroke (31% vs. 64%, p < .001) compared to those without sCM. The estimated monthly increase in KCCQ scores following...Continue Reading
References
Oct 3, 2012·European Heart Journal·A Pieter KappeteinMartin B Leon
Nov 21, 2012·Heart·Stefan StorteckyStephan Windecker
Dec 12, 2012·Journal of Cardiovascular Computed Tomography·Stephan AchenbachJonathon A Leipsic
Sep 12, 2013·Circulation. Cardiovascular Quality and Outcomes·Suzanne V ArnoldDavid J Cohen
Oct 22, 2013·Journal of the American College of Cardiology·Danny DvirAugusto D Pichard
Oct 26, 2013·JACC. Cardiovascular Interventions·Michael MokJosep Rodés-Cabau
Mar 19, 2014·The American Journal of Cardiology·Romain ChopardFrancois Schiele
Apr 18, 2014·Heart·Bernard IungUNKNOWN FRANCE 2 Investigators
May 7, 2014·European Heart Journal·Ricardo AllendeJosep Rodés-Cabau
Jun 24, 2014·JACC. Cardiovascular Interventions·Brian R LindmanJonathan Afilalo
Jun 25, 2014·Circulation·Suzanne V ArnoldUNKNOWN PARTNER Investigators
Jan 21, 2015·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Atsushi OguriUNKNOWN FRANCE 2 Registry investigators
Mar 11, 2015·JAMA : the Journal of the American Medical Association·David R HolmesUNKNOWN STS/ACC TVT Registry
Mar 20, 2015·Lancet·Michael J MackUNKNOWN PARTNER 1 trial investigators
Sep 4, 2015·The Annals of Thoracic Surgery·Rakesh M SuriDavid R Holmes
Jan 29, 2016·European Heart Journal·Rishi PuriJosep Rodés-Cabau
Apr 5, 2016·The New England Journal of Medicine·Martin B LeonUNKNOWN PARTNER 2 Investigators
Apr 8, 2016·Lancet·Vinod H ThouraniMartin B Leon
Jun 22, 2016·The American Journal of Cardiology·Yusuke WatanabeKentaro Hayashida
Oct 22, 2016·Journal of the American College of Cardiology·Suzanne V ArnoldUNKNOWN U.S. CoreValve Investigators
Feb 2, 2017·JAMA Cardiology·Suzanne V ArnoldDavid J Cohen
Mar 18, 2017·Circulation·Tetsuro ShimuraUNKNOWN OCEAN-TAVI Investigators
Apr 1, 2017·European Heart Journal Cardiovascular Imaging·Helmut BaumgartnerCatherine M Otto
May 4, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Alexis K OkohMark J Russo
Aug 11, 2017·Circulation. Cardiovascular Interventions·Matthew D SayboltHoward C Herrmann
Aug 22, 2017·The American Journal of Cardiology·Nirmanmoh BhatiaJoseph L Fredi
Sep 10, 2017·European Heart Journal·Helmut BaumgartnerUNKNOWN ESC Scientific Document Group
Oct 19, 2017·The American Journal of Cardiology·Oren ZusmanUri Landes
Oct 21, 2017·JACC. Cardiovascular Interventions·Tanush GuptaDeepak L Bhatt
Oct 21, 2017·JACC. Cardiovascular Interventions·Paul SorajjaJeffrey J Popma
Nov 6, 2017·JACC. Cardiovascular Interventions·Juan A CrestanelloMichael J Reardon
Nov 23, 2017·Journal of Interventional Cardiology·Norman MangnerAxel Linke
Dec 9, 2017·Heart·Glen P MartinMamas A Mamas
Feb 10, 2018·The American Journal of Cardiology·Toby RogersRon Waksman
Jun 6, 2018·Circulation. Cardiovascular Interventions·Gabriela Tirado-ConteLuis Nombela-Franco
Sep 27, 2018·Journal of the American College of Cardiology·Thomas G GleasonUNKNOWN CoreValve U.S. Pivotal High Risk Trial Clinical Investigators
Oct 26, 2018·Circulation. Cardiovascular Quality and Outcomes·Suzanne V ArnoldJ Matthew Brennan
Dec 12, 2018·The American Journal of Cardiology·Liang TangPaul Sorajja
Dec 19, 2018·Circulation. Cardiovascular Interventions·Liang TangPaul Sorajja
Jan 10, 2019·JACC. Cardiovascular Interventions·Uri LandesRan Kornowski
Mar 19, 2019·The New England Journal of Medicine·Jeffrey J PopmaUNKNOWN Evolut Low Risk Trial Investigators
Mar 19, 2019·The New England Journal of Medicine·Michael J MackUNKNOWN PARTNER 3 Investigators
Jul 10, 2019·Current Cardiology Reports·Serban Mihai BalanescuCezar Iliescu