Key result
Metastatic cancer linked to ~428% higher mortality after TAVI, unlike active non-metastatic cancer.
Why the study?
Malignancy is common in older adults undergoing TAVI and may affect prognosis, but whether active cancer affects all-cause mortality rates remained to be clarified.
Does active cancer affect all-cause mortality in patients undergoing transcatheter aortic valve implantation?
Observational (n=1,114)
Yes
Does active cancer affect all-cause mortality in patients undergoing transcatheter aortic valve implantation?
Active cancer without metastasis does not negatively impact mid-term survival after TAVI, suggesting TAVI is a viable option for these patients, whereas cancer metastasis is associated with significantly increased mortality.
Answers are grounded in this paper and cite their sources.
Metastatic cancer was associated with higher post-TAVI mortality while non-metastatic disease was not; leaves open whether cancer staging should guide TAVI selection.
Malignancy is common in older adults undergoing transcatheter aortic valve implantation (TAVI), and may affect prognosis. The present study aimed to examine whether active cancer affects all-cause mortality rates among patients undergoing TAVI. This retrospective study examined data from 1,114 consecutive patients treated between April 2010 and June 2019. Patients with life expectancy of <1 year due to non-cardiac causes were excluded. Active cancer was defined as cancer under treatment or cured within 1 year, and was recognized in 62 patients (5.6%) with (n = 17) and without (n = 45) metastases. In multivariate analysis, being female (hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.39–0.77, p < 0.001), body mass index (BMI) (HR = 0.92 per 1 kg/m2 increase, 95% CI 0.87–0.97, p = 0.001), New York Heart Association (NYHA) class III/IV (HR = 1.53, 95% CI 1.06–2.20, p = 0.022), atrial fibrillation (HR = 2.40, 95% CI 1.70–3.38, p < 0.001), albumin levels (HR = 0.41 per 1-g/dl, 95% CI 0.30–0.57, p < 0.001), and cancer metastasis (HR = 5.28, 95% CI 1.86–14.9, p = 0.001) were associated with all-cause mortality after TAVI. In patients undergoing TAVI, being female, high BMI, NYHA class III/IV, atrial fibrillation, albumin levels, and cancer metastasis were factors associated with mortality. Meanwhile, active cancer without metastasis was not associated with increased mortality rates. These findings would help clinical decision-making by patients and physicians. Clinical trial registration: UMIN000031133.
No takes yet. Share an insight, caveat, or question.
Kojima et al. (2022) conducted an observational in Severe aortic stenosis undergoing transcatheter aortic valve implantation (n=1,114). Active cancer (with or without metastasis) vs. No active cancer was evaluated on All-cause mortality (HR 5.28, 95% CI 1.86-14.9, p=0.001). In patients undergoing transcatheter aortic valve implantation, cancer metastasis was significantly associated with increased all-cause mortality (HR 5.28), whereas active cancer without metastasis was not.
Synapse has enriched 10 related papers. Consider them for comparative context: