Benenati, Stefano; Gallo, Francesco; Kim, Won-Keun; Khokhar, Arif A; Zeus, Tobias; Toggweiler, Stefan; Galea, Roberto; De Marco, Federico; Mangieri, Antonio; Regazzoli, Damiano; Reimers, Bernhard; Nombela-Franco, Luis; Barbanti, Marco; Regueiro, Ander; Piva, Tommaso; Rodes-Cabau, Josep; Porto, Italo; Colombo, Antonio; Giannini, Francesco and Sticchi, Alessandro (2024). Comparison of Mid-Term Prognosis in Intermediate-to-Low-Risk Contemporary Population with Guidelines-Oriented Age Cutoff. Journal of cardiovascular development and disease, 11(1) MDPI 10.3390/jcdd11010033
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BACKGROUND
Current European guidelines support transcatheter aortic valve implantation (TAVI) in intermediate-to-low-risk patients ≥75 years-old, but its prognostic relevance is unknown.
METHODS
Intermediate-to-low-risk (The Society of Thoracic Surgeons score <8%) patients enrolled in the HORSE registry were included. We compared the populations aged under 75 with those over 75. The primary endpoint was all-cause mortality.
RESULTS
A total of 2685 patients were included: 280 (8.6%) < 75 and 2405 ≥ 75 years. Through a mean follow-up of 437 ± 381 days, 198 (8.2%) and 23 (8.2%) patients died in the two arms without statistically significant differences (log-rank p = 0.925). At Cox regression analysis, age did not predict the occurrence of all-cause death, neither as a continuous variable (HR 1.01, 95% CI 0.99-1.04, p = 0.294) nor dichotomizing according to the prespecified cutoff of 75 years (HR 0.97, 95% CI 0.63-1.51, p = 0.924). Time-to-event ROC curves showed low accuracy of age to predict all-cause mortality (area under the curve of 0.54 for both 1-year and 2-year outcomes).
CONCLUSIONS
TAVI has comparable benefits across age strata for intermediate-to-low-risk patients. The age cutoff suggested by the current guidelines is not predictive of the risk of adverse events during hospital stays or of all-cause mortality through a mid-term follow-up.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Galea, Roberto |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2308-3425 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
29 Jan 2024 11:05 |
Last Modified: |
04 Mar 2024 13:36 |
Publisher DOI: |
10.3390/jcdd11010033 |
PubMed ID: |
38276659 |
Uncontrolled Keywords: |
age aortic stenosis low–intermediate risk surgical risk transcatheter aortic valve replacement |
BORIS DOI: |
10.48350/192182 |
URI: |
https://boris.unibe.ch/id/eprint/192182 |
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