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November 18, 2023The American Journal of CardiologyOpen Access

Temporal Trends in Patient Characteristics and Outcomes of Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement: A Nationwide Study

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Why the study?

With the expanding use of TAVI for aortic stenosis, evaluating real-life temporal trends in patient characteristics and clinical outcomes is important.

What are the temporal trends in patient characteristics, complications, and mortality among patients undergoing first-time TAVI?

Population

4,847 consecutive Danish patients undergoing first-time TAVI from 2010 to 2019

Comparison

Temporal trends over time (2010 to 2019)

Design

Nationwide register-based cohort study

Follow-up

90 days

Key result

In a nationwide Danish cohort, 30-day all-cause mortality after first-time TAVI significantly decreased from 6.7% in 2011 to 1.5% in 2019, alongside reductions in pacemaker implantation and heart failure.

Authors

CLCamilla LundahlKKKristian KragholmBTBhupendar Tayal

Discussion

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Overview

Short-term Danish TAVI mortality and complications declined over time; leaves open generalizability and causal drivers.

Key Points

  • To evaluate trends in patient characteristics and outcomes related to transcatheter aortic valve implantation (TAVI) in Denmark from 2010 to 2019.
  • Nationwide register-based study of first-time consecutive Danish patients undergoing TAVI from 2010 to 2019
  • Statistical analyses included chi-square tests, Kruskal-Wallis tests, and Cochrane-Armitage trend tests
  • Analysis of complications and mortality data collected from national health registries.
  • 30-day all-cause mortality decreased from 6.7% in 2011 to 1.5% in 2019 (p<0.001)
  • 90-day all-cause mortality decreased from 9.2% in 2011 to 2.7% in 2019 (p<0.001)
  • Incidence of heart failure after 30 days significantly dropped from 19.3% to 8.5%.

Study Design

Type

Cohort (n=4,847)

Multicenter

Yes

Structured PICO

What are the temporal trends in patient characteristics, complications, and mortality among patients undergoing first-time TAVI?

P
Population
4,847 consecutive Danish patients (median age 82) who underwent first-time transcatheter aortic valve implantation between 2010 and 2019, evaluated for temporal trends in 30- and 90-day outcomes.
E
Exposure
Transcatheter aortic valve implantation (TAVI) via percutaneous transfemoral, transapical, or transaortic access
O
Outcome
Temporal trends in 30- and 90-day all-cause mortality and complications (pacemaker implantation, atrial fibrillation, stroke/transient ischemic attack, and heart failure)hard clinical

Main Result

Absolute Event Rate: 1.5% vs 6.7%

Real-world nationwide data from Denmark demonstrate significant reductions in 30- and 90-day mortality and complications (such as pacemaker implantation and heart failure) following TAVI from 2010 to 2019.

Cite This Study

Lundahl et al. (2023) conducted a cohort in Aortic stenosis (n=4,847). Transcatheter aortic valve implantation (TAVI) vs. Earlier calendar years (2011) was evaluated on 30-day all-cause mortality. In a nationwide Danish cohort, 30-day all-cause mortality after first-time TAVI significantly decreased from 6.7% in 2011 to 1.5% in 2019, alongside reductions in pacemaker implantation and heart failure.

synapsesocial.com/papers/6a49a024bf54f04e123b45dehttps://doi.org/10.1016/j.amjcard.2023.11.024
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