Early heart failure hospitalization after TAVR occurred in nearly 20% of patients and was strongly associated with increased mortality (adjusted HR 3.17; 95% CI 3.11-3.22).
Cohort
Does early post-TAVR heart failure hospitalization increase mortality in older patients?
Nearly 20% of older adults experience early heart failure hospitalization after TAVR, which is associated with a more than 3-fold increase in mortality.
Effect estimate: HR 3.17 (95% CI 3.11-3.22)
BACKGROUND: Transcatheter aortic valve replacement (TAVR) improves symptoms and survival in patients with severe aortic stenosis, yet the incidence and prognostic significance of early postprocedural heart failure (HF) hospitalization remain incompletely characterized. Our objective is to determine the incidence, clinical characteristics, prognostic implications, and predictors of early HF hospitalization after TAVR. METHODS: Using the Medicare Provider Analysis and Review database, we identified fee-for-service beneficiaries ≥65 years who underwent TAVR between January 1, 2017, and November 30, 2021. Early post-TAVR HF hospitalization was defined as at least 1 HF readmission occurring between 31 and 365 days after the index procedure. Patients were classified according to the presence or absence of HF hospitalization during this period. Cox proportional hazards models were used to evaluate the association with mortality after adjustment for clinical, procedural, and sociodemographic factors. RESULTS: <0.001). After multivariable adjustment, early HF hospitalization was strongly associated with increased mortality (adjusted hazard ratio HR, 3.17 95% CI, 3.11-3.22). The strongest predictors of early HF hospitalization were advanced cardiac damage stage (adjusted-subdistribution HR, 1.95 95% CI, 1.88-2.02) and high-risk frailty (adjusted-subdistribution HR, 1.65 95% CI, 1.58-1.72), with graded risk across stages. CONCLUSIONS: Nearly 1 in 5 older adults undergoing TAVR experience early HF hospitalization, which is associated with markedly increased short- and long-term mortality.
Kundi et al. (Mon,) conducted a cohort in Severe aortic stenosis. Early post-TAVR heart failure hospitalization vs. No early heart failure hospitalization was evaluated on Mortality (HR 3.17, 95% CI 3.11-3.22). Early heart failure hospitalization after TAVR occurred in nearly 20% of patients and was strongly associated with increased mortality (adjusted HR 3.17; 95% CI 3.11-3.22).