041 Serial change in health related quality of life over 1 year following transcatheter aortic valve implantation: predictors of health outcomes

Introduction Severe aortic stenosis (AS) reduces the length and quality of a patient's life. Transcatheter Aortic Valve Implantation (TAVI) is superior to standard medical therapy and non-inferior to Surgical Aortic Valve Replacement (SAVR) for 1-year mortality. HRQOL is an important outcome measure, for which there is limited evidence in TAVI populations. This study aimed to assess serial changes in patient health related quality of life (HRQOL) over time and identify predictors of patient benefit. Method 102 (age 80±0.6 years, female 51%) attending for TAVI consented to participate. Two HRQOL questionnaires, the SF12v2 with physical and mental component summaries (PCS and MCS) and the EQ-5D (with Visual Analogue Scale; VAS) were completed at baseline, 30 days, 6 and 12 months. A SF-6D utility measure was calculated from the SF12 survey. Results HRQOL significantly improved over 12 months (PCS, p=0.002; EQ-5D, p=0.02; VAS, p=0.01; SF-6D p=0.048). The greatest change occurred from baseline to 30 days (p<0.001) with further significant increases to 6 months (p<0.01). An insignificant decline occurred between 6 and 12 months (p>0.05), Abstract 041 table 1. Female gender (p<0.05), age ≥80 years (p<0.05), previous MI (p<0.04), CKD (p<0.05), pulmonary hypertension (p=0.04) and lower operator experience (p<0.001) were independent predictors of a smaller improvement in HRQOL, Abstract 041 figure 1. Abstract 041 Table 1 Health survey US norm* Baseline n=99 Time-point p Value† 30 days n=90 6 months n=70 12 months n=55 PCS 37.3±3 29.5±9 36.4±9 38.3±11 35.8±10 0.002 MCS 51±3 45±12 46.4±13 47.4±11 45.2±11 0.45 EQ-5D 0.66±0.2 0.54±0.3 0.65±0.3 0.68±0.3 0.59±0.3 0.02 VAS 0.53±7 51.1±21 61.4±21 68.2±20 56.2±28 0.01 SF-6D 0.72±0.1 0.60±0.1 0.66±0.1 0.68±0.1 0.62±0.1 0.048 Values are mean±SD. * US Norms are reported for a US population stratified by age (80–89 years). † p Values are reported for a change in health and were calculated by repeated measures ANOVA. Numbers reflect the patients who completed the 4 time-points questionnaires entered into the analysis. PCS, physical component score; MCS, mental component score; VAS, visual analogue score. Abstract 041 Figure 1 Operation order. Conclusions HRQOL significantly improves early following TAVI and is maintained out to 1 year. Patient and procedural predictors of health benefit at 1 year may help patients and physicians make a fully informed decision during the TAVI selection process.