Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis

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 inco...

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Autores: Lopez-Martinez, Helena|||0000-0002-0963-0207, Vilalta, Victoria|||0000-0003-1767-5963, Farjat-Pasos, J., Ferrer-Sistach, Elena|||0000-0002-1795-2193, Mohammadi, S., Escabia, Claudia|||0000-0002-8076-3539, Kalavrouziotis, D., Resta, Helena|||0000-0001-7323-5589, Borrellas, Andrea, Dumont, E., Carrillo, Xavier|||0000-0001-6691-8859, Paradis, J.M., Fernandez-Nofrerias, Eduard|||0000-0003-2219-921X, Delgado, Victoria|||0000-0002-9841-2737, Rodés-Cabau, J., Bayés-Genís, Antoni|||0000-0002-3044-197X
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:311655
Acceso en línea:https://ddd.uab.cat/record/311655
https://dx.doi.org/urn:doi:10.1002/ehf2.14887
Access Level:acceso abierto
Palabra clave:Aortic stenosis cardiomyopathy
Aortic valve stenosis
Heart failure
Mortality
Prostheses and implants
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spelling Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosisLopez-Martinez, Helena|||0000-0002-0963-0207Vilalta, Victoria|||0000-0003-1767-5963Farjat-Pasos, J.Ferrer-Sistach, Elena|||0000-0002-1795-2193Mohammadi, S.Escabia, Claudia|||0000-0002-8076-3539Kalavrouziotis, D.Resta, Helena|||0000-0001-7323-5589Borrellas, AndreaDumont, E.Carrillo, Xavier|||0000-0001-6691-8859Paradis, J.M.Fernandez-Nofrerias, Eduard|||0000-0003-2219-921XDelgado, Victoria|||0000-0002-9841-2737Rodés-Cabau, J.Bayés-Genís, Antoni|||0000-0002-3044-197XAortic stenosis cardiomyopathyAortic valve stenosisHeart failureMortalityProstheses and implantsAims: 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.Universitat Autònoma de Barcelona 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/311655https://dx.doi.org/urn:doi:10.1002/ehf2.14887reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest 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.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3116552026-06-06T12:50:31Z
dc.title.none.fl_str_mv Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
title Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
spellingShingle Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
Lopez-Martinez, Helena|||0000-0002-0963-0207
Aortic stenosis cardiomyopathy
Aortic valve stenosis
Heart failure
Mortality
Prostheses and implants
title_short Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
title_full Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
title_fullStr Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
title_full_unstemmed Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
title_sort Heart failure hospitalization following surgical or transcatheter aortic valve implantation in low-risk aortic stenosis
dc.creator.none.fl_str_mv Lopez-Martinez, Helena|||0000-0002-0963-0207
Vilalta, Victoria|||0000-0003-1767-5963
Farjat-Pasos, J.
Ferrer-Sistach, Elena|||0000-0002-1795-2193
Mohammadi, S.
Escabia, Claudia|||0000-0002-8076-3539
Kalavrouziotis, D.
Resta, Helena|||0000-0001-7323-5589
Borrellas, Andrea
Dumont, E.
Carrillo, Xavier|||0000-0001-6691-8859
Paradis, J.M.
Fernandez-Nofrerias, Eduard|||0000-0003-2219-921X
Delgado, Victoria|||0000-0002-9841-2737
Rodés-Cabau, J.
Bayés-Genís, Antoni|||0000-0002-3044-197X
author Lopez-Martinez, Helena|||0000-0002-0963-0207
author_facet Lopez-Martinez, Helena|||0000-0002-0963-0207
Vilalta, Victoria|||0000-0003-1767-5963
Farjat-Pasos, J.
Ferrer-Sistach, Elena|||0000-0002-1795-2193
Mohammadi, S.
Escabia, Claudia|||0000-0002-8076-3539
Kalavrouziotis, D.
Resta, Helena|||0000-0001-7323-5589
Borrellas, Andrea
Dumont, E.
Carrillo, Xavier|||0000-0001-6691-8859
Paradis, J.M.
Fernandez-Nofrerias, Eduard|||0000-0003-2219-921X
Delgado, Victoria|||0000-0002-9841-2737
Rodés-Cabau, J.
Bayés-Genís, Antoni|||0000-0002-3044-197X
author_role author
author2 Vilalta, Victoria|||0000-0003-1767-5963
Farjat-Pasos, J.
Ferrer-Sistach, Elena|||0000-0002-1795-2193
Mohammadi, S.
Escabia, Claudia|||0000-0002-8076-3539
Kalavrouziotis, D.
Resta, Helena|||0000-0001-7323-5589
Borrellas, Andrea
Dumont, E.
Carrillo, Xavier|||0000-0001-6691-8859
Paradis, J.M.
Fernandez-Nofrerias, Eduard|||0000-0003-2219-921X
Delgado, Victoria|||0000-0002-9841-2737
Rodés-Cabau, J.
Bayés-Genís, Antoni|||0000-0002-3044-197X
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Aortic stenosis cardiomyopathy
Aortic valve stenosis
Heart failure
Mortality
Prostheses and implants
topic Aortic stenosis cardiomyopathy
Aortic valve stenosis
Heart failure
Mortality
Prostheses and implants
description 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.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/311655
https://dx.doi.org/urn:doi:10.1002/ehf2.14887
url https://ddd.uab.cat/record/311655
https://dx.doi.org/urn:doi:10.1002/ehf2.14887
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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