In:
Catheterization and Cardiovascular Interventions, Wiley, Vol. 97, No. 1 ( 2021-01)
Abstract:
The purpose of this study was to investigate 30‐day and 2‐year clinical outcomes, and predictors of 2‐year mortality in nonagenarians undergoing transcatheter aortic valve implantation (TAVI). Background TAVI has been applied to nonagenarians. However, sufficient clinical data in nonagenarians who could benefit from TAVI are limited. Methods We evaluated the data from the optimized catheter valvular intervention‐TAVI registry. Clinical outcomes were compared between patients' age ≥90 years and age 〈 90 years. Predictive factors of 2‐year mortality were assessed by multivariable Cox regression analyses. Results From October 2013 to May 2017, a total of 375 nonagenarians (age ≥90 years) and 2,213 younger patients (age 〈 90 years) were included. Although nonagenarians had a higher surgical risk score, 30‐day clinical outcomes were similar between two groups. There were no significant differences in 2‐year mortality (22.0% vs. 17.3%; p = .11) and stroke (5.5% vs. 3.9%; p = .31); however, 2‐year heart failure readmission was higher in nonagenarians (13.3% vs. 9.0%; p = .03). After adjusting covariates, age ≥90 years was not independent predictor for 2‐year outcomes. In nonagenarians, female sex (hazard ratio [HR] = 0.43; 95% confidence interval [CI] = 0.26–0.74; p = .002), chronic kidney disease grade ≥4 (HR = 2.14; 95% CI = 1.21–3.64; p = .01), and Clinical Frailty Scale ≥4 (HR = 1.82; 95% CI = 1.02–3.42; p = .04) were independently associated with 2‐year mortality. Conclusions Clinical outcomes of TAVI in selected nonagenarians were favorable. Severe renal dysfunction and frailty may be important factors to predict mid‐term mortality after TAVI in nonagenarians.
Type of Medium:
Online Resource
ISSN:
1522-1946
,
1522-726X
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2001555-0