Why the study?
To assess the utilization of aortic valve replacements in heart failure patients with concomitant aortic stenosis or combined aortic stenosis and regurgitation.
Does aortic valve replacement (TAVI or SAVR) improve short-term outcomes in heart failure patients with aortic stenosis compared to no intervention?
Cohort
Yes
Does aortic valve replacement (TAVI or SAVR) improve short-term outcomes in heart failure patients with aortic stenosis compared to no intervention?
Answers are grounded in this paper and cite their sources.
A large majority of heart failure patients with aortic stenosis do not undergo aortic valve replacement, which is associated with worse short-term outcomes.
Study objective: Assess the utilization of aortic valve replacements (AVR). Design: Retrospective analysis of the Nationwide Readmissions Database (2016-2018). Setting: Nationwide. Participants: Heart failure patients with concomitant aortic stenosis (CHF + AS cohort) or aortic stenosis with aortic regurgitation (CHF + AS+AR cohort). Interventions: Transcatheter aortic valve implantation (TAVI), surgical aortic valve replacement (SAVR), no-AVR. Main outcome measures: Utilization of treatment interventions. Results: In the CHF + AS cohort, TAVI, SAVR and no-AVR were done in 9.3 %, 10.8 % and 79.9 % of patients respectively. Similarly, majority of CHF + AS+AR patients were managed with no-AVR (53.2 %). Of patients managed with no-AVR in the first six months of each year, only 7.9 % of CHF + AS and 11.8 % of CHF + AS+AR patients underwent AVR in the subsequent six months of the year. No-AVR patients had worse short-term outcomes in comparison to AVR recipients. Conclusion: More studies are needed to understand the timing, indications and utilization of AVR in this population.
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Shekhar et al. (2022) conducted a cohort in Heart failure with aortic stenosis or aortic stenosis with aortic regurgitation. Aortic valve replacement (TAVI or SAVR) vs. No aortic valve replacement was evaluated on Utilization of treatment interventions.