Transcatheter aortic valve replacement outcomes in patients with sarcopaenia

AIMS Sarcopenia is a prevalent disease of aging, associated with adverse clinical outcomes. We compared in-hospital adverse outcomes and overall mortality in sarcopenic and non-sarcopenic patients undergoing Transcatheter Aortic Valve Replacement (TAVR). METHODS AND RESULTS This is a retrospective cohort study including 602 patients who underwent TAVR. Sarcopenia was defined as skeletal muscle mass index < 55.4 cm2/m2 in males and < 38.9 cm2/m2 in females obtained through pre-TAVR CT scan. Mortality, length of hospital stay, ICU admission, and Valve Academic Research Consortium (VARC)-2 defined post-TAVR complications were defined as outcomes. Study participants (mean age 80.9 ± 8.9 years and 56.8% male) were followed for a median of 1.5 years. Two-thirds of the TAVR population was sarcopenic. In-hospital outcomes were similar in both groups, but overall survival was worse in sarcopenic patients (HR for mortality= 1.46 (1.06-2.14), P=0.02). In multivariable model, sarcopenia, porcelain aorta, pre-TAVR atrial fibrillation/flutter, severe chronic kidney disease, chronic pulmonary disease, (VARC)-2 bleeding, acute renal failure following TAVR, and post-TAVR cardiac arrest were predictors of mortality. CONCLUSIONS Sarcopenic patients had similar in-hospital clinical outcomes as non-sarcopenic patients following TAVR which reveals TAVR safety in sarcopenic patients. However, sarcopenia was an independent risk factor for mid-term mortality proposing for its potential value in systematic evaluation of this highly comorbid population to decide the best treatment approaches.