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Mortality and morbidity after transcatheter aortic valve implantation compared to an age- and sex-matched control population : a population-based study from the SWEDEHEART registry

Lachonius, Maria ; Nielsen, Susanne J. ; Giang, Kok Wai ; Backes, Jenny ; Bjursten, Henrik LU ; Hagström, Henrik ; James, Stefan ; Settergren, Magnus ; Skoglund, Kristofer and Jeppsson, Anders , et al. (2025) In European Heart Journal - Quality of Care and Clinical Outcomes 11(5). p.614-621
Abstract

Introduction Data are lacking about the risk for death and major adverse cardiovascular events (MACE) after transcatheter aortic valve implantation (TAVI), compared to the general population. Therefore, we assessed the risk for all-cause death and MACE after TAVI in patients aged 65 years and older, in comparison to an age- and sex-matched control population. Methods and results In total, 5924 TAVI patients and 10 928 matched controls [mean age 82.1, standard deviation (SD) 6.0, and 81.9, SD 6.1, respectively] were included from 2014 to 2020. The SWEDEHEART registry and four mandatory national registers were used to collect data. Cox regression models were used to assess the association with all-cause mortality and MACE risk. In total,... (More)

Introduction Data are lacking about the risk for death and major adverse cardiovascular events (MACE) after transcatheter aortic valve implantation (TAVI), compared to the general population. Therefore, we assessed the risk for all-cause death and MACE after TAVI in patients aged 65 years and older, in comparison to an age- and sex-matched control population. Methods and results In total, 5924 TAVI patients and 10 928 matched controls [mean age 82.1, standard deviation (SD) 6.0, and 81.9, SD 6.1, respectively] were included from 2014 to 2020. The SWEDEHEART registry and four mandatory national registers were used to collect data. Cox regression models were used to assess the association with all-cause mortality and MACE risk. In total, 1410 (23.8%) of the TAVI patients and 2115 (19.4%) controls died during the follow-up period. Median follow-up was 1.9 years (inter quartile range 0.9–3.3) respectively. The crude mortality and MACE risks were higher in TAVI patients than in controls {hazard ratios 1.27 [95% Confidence interval (CI): 1.19–1.36] and HR 1.44 (95% CI: 1.35–1.53), respectively}. After adjustment, there was a lower risk for both mortality and MACE in TAVI patients [adjusted hazard ratio (aHR) 0.77 (95% CI: 0.71–0.84) and aHR 0.90 (95% CI: 0.83–0.98), respectively]. Conclusion After adjustments for comorbidities, the mortality risk was lower in TAVI patients, compared with an age- and sex-matched control population. These findings suggest that the high burden of comorbidities in TAVI patients has a strong impact on the risk for mortality and MACE after TAVI.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular risk factors, Morbidity, Mortality risk, Survival, Transcatheter aortic valve implantation
in
European Heart Journal - Quality of Care and Clinical Outcomes
volume
11
issue
5
pages
614 - 621
publisher
Oxford University Press
external identifiers
  • pmid:39924172
  • scopus:105013057760
ISSN
2058-5225
DOI
10.1093/ehjqcco/qcaf008
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.
id
a131de3a-f0bb-4fc3-88ef-07e71bccc3f8
date added to LUP
2025-08-28 09:12:21
date last changed
2025-08-29 03:00:07
@article{a131de3a-f0bb-4fc3-88ef-07e71bccc3f8,
  abstract     = {{<p>Introduction Data are lacking about the risk for death and major adverse cardiovascular events (MACE) after transcatheter aortic valve implantation (TAVI), compared to the general population. Therefore, we assessed the risk for all-cause death and MACE after TAVI in patients aged 65 years and older, in comparison to an age- and sex-matched control population. Methods and results In total, 5924 TAVI patients and 10 928 matched controls [mean age 82.1, standard deviation (SD) 6.0, and 81.9, SD 6.1, respectively] were included from 2014 to 2020. The SWEDEHEART registry and four mandatory national registers were used to collect data. Cox regression models were used to assess the association with all-cause mortality and MACE risk. In total, 1410 (23.8%) of the TAVI patients and 2115 (19.4%) controls died during the follow-up period. Median follow-up was 1.9 years (inter quartile range 0.9–3.3) respectively. The crude mortality and MACE risks were higher in TAVI patients than in controls {hazard ratios 1.27 [95% Confidence interval (CI): 1.19–1.36] and HR 1.44 (95% CI: 1.35–1.53), respectively}. After adjustment, there was a lower risk for both mortality and MACE in TAVI patients [adjusted hazard ratio (aHR) 0.77 (95% CI: 0.71–0.84) and aHR 0.90 (95% CI: 0.83–0.98), respectively]. Conclusion After adjustments for comorbidities, the mortality risk was lower in TAVI patients, compared with an age- and sex-matched control population. These findings suggest that the high burden of comorbidities in TAVI patients has a strong impact on the risk for mortality and MACE after TAVI.</p>}},
  author       = {{Lachonius, Maria and Nielsen, Susanne J. and Giang, Kok Wai and Backes, Jenny and Bjursten, Henrik and Hagström, Henrik and James, Stefan and Settergren, Magnus and Skoglund, Kristofer and Jeppsson, Anders and Pétursson, Pétur}},
  issn         = {{2058-5225}},
  keywords     = {{Cardiovascular risk factors; Morbidity; Mortality risk; Survival; Transcatheter aortic valve implantation}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{5}},
  pages        = {{614--621}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal - Quality of Care and Clinical Outcomes}},
  title        = {{Mortality and morbidity after transcatheter aortic valve implantation compared to an age- and sex-matched control population : a population-based study from the SWEDEHEART registry}},
  url          = {{http://dx.doi.org/10.1093/ehjqcco/qcaf008}},
  doi          = {{10.1093/ehjqcco/qcaf008}},
  volume       = {{11}},
  year         = {{2025}},
}