Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
Lopez-Martinez, Helena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vilalta, Victoria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Farjat-Pasos, J. (Laval University)
Ferrer-Sistach, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Mohammadi, S. (Laval University)
Escabia, Claudia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Kalavrouziotis, D. (Laval University)
Resta, Helena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Borrellas, Andrea (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Dumont, E. (Laval University)
Carrillo, Xavier (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Paradis, J.M. (Laval University)
Fernandez-Nofrerias, Eduard (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Delgado, Victoria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rodés-Cabau, J. (Laval University)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Aims: In low-risk patients with severe aortic stenosis (AS), sutureless surgical aortic valve replacement (SU-SAVR) may be an alternative to transcatheter aortic valve implantation (TAVI). The risk of heart failure hospitalization (HFH) after aortic valve replacement (AVR) in this population is incompletely characterized. This study aims to investigate the incidence, predictors, and outcomes of HFH in patients undergoing SU-SAVR versus TAVI. Methods and results: Patients referred for AVR between 2013 and 2020 at two centres were consecutively included. The decision for SU-SAVR or TAVI was determined by a multidisciplinary Heart Team. Cox regression and competing risk analysis were conducted to assess adverse events. Of 594 patients (mean age 77. 5 ± 6. 4, 59. 8% male), 424 underwent SU-SAVR, while 170 underwent TAVI. Following a mean follow-up of 34. 1 ± 23. 1 months, HFH occurred in 112 (27. 8%) SU-SAVR patients and in 8 (4. 8%) TAVI patients (P < 0. 001). The SU-SAVR cohort exhibited higher all-cause mortality (138 [32. 5%] patients compared with 30 [17. 6%] in the TAVI cohort [P < 0. 001]). These differences remained significant after sensitivity analyses with 1:1 propensity score matching for baseline variables. SU-SAVR with HFH was associated with increased all-cause mortality (61. 6% vs. 23. 1%, P < 0. 001). Independent associates of HFH in SU-SAVR patients included diabetes, atrial fibrillation, chronic obstructive pulmonary disease, lower glomerular filtration rate and lower left ventricular ejection fraction. SU-SAVR patients with HFH had a 12-month LVEF of 59. 4 ± 12. 7. Conclusions: In low-risk AS, SU-SAVR is associated with a higher risk of HFH and all-cause mortality compared to TAVI. In patients with severe AS candidate to SU-SAVR or TAVI, TAVI may be the preferred intervention.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Aortic stenosis cardiomyopathy ; Aortic valve stenosis ; Heart failure ; Mortality ; Prostheses and implants
Published in:	ESC Heart Failure, Vol. 11 Núm. 5 (october 2024) , p. 2531-2541, ISSN 2055-5822

DOI: 10.1002/ehf2.14887
PMID: 38894578

11 p, 1.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles