To date, long-term outcome data following transcatheter aortic valve replacement (TAVR) has only been available from clinical trial data.\u00a0 Evaluating long-term outcomes of TAVR in real-world use is important to ensure the anticipated benefits are observed in routine clinical practice. \u00a0Using data from the Society of Thoracic Surgeons\/American College of Cardiology (STS\/ACC) Transcatheter Valve therapies registry merged with Centers for Medicare & Medicaid Services administrative claims data, this study evaluated 1-year outcomes of mortality, stroke, and rehospitalization among 12,182 patients who underwent TAVR between November 2011 and June 2013.\u00a0 In this cohort, the 1-year mortality rate 23.7%, the stroke rate was 4.1%, the rate of heart failure was 14.3%, and 1.4% had aortic valve reintervention.\u00a0 A total of 53.2% were readmitted to the hospital within 1-year.\u00a0 \u00a0In multivariate analysis, patient characteristics associated with increased mortality included advancing age (age >95 hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.24 to 2.09), male gender (HR 1.21; 95% CI 1.12 to 1.31), severe lung disease (HR 1.39; 95% CI 1.25 to 1.55), renal failure (dialysis HR 1.66; 95% CI 1.41 to 1.95) and Cr > 2mg\/dL (HR 1.26; 95%CI 1.10 to 1.44), nontransfemoral access (HR 1.37; 95% CI 1.27 to 1.28), and STS Predicted Risk of Mortality (PROM) score greater than 15% compared with less than 8% (HR 1.82; 95% CI 1.60 to 2.06).\u00a0 In addition, the authors found the median predicted mortality for this cohort was 7.1% which was lower than the median predicted mortality for patients in the clinical trials that established the efficacy of TAVR (~11% in these prior trials).<\/p>\n
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Conclusion:<\/strong> The 1-year outcomes of patients undergoing TAVR are similar to outcomes seen during prior clinical trials with a 1-year mortality of 23.7% and stroke 4.1%.\u00a0 However, the lower predicted mortality in this observational cohort may reflect use of TAVR in a lower risk population than prior clinical trials.<\/p>\n <\/p>\n Summarized by Lauren E. Thompson and Steven M. Bradley<\/p>\n <\/p>\n