Temporal trends in utilization of transcatheter aortic valve replacement and patient characteristics: A nationwide study.

ABSTRACT

AIM: To investigate trends in the utilization of transcatheter aortic valve replacement (TAVR) and changes in the characteristics of patients undergoing first-time TAVR. METHODS: Using Danish nationwide registers, we included all patients undergoing TAVR between 2008 and 2020. To compare patient characteristics, the study population was stratified according to calendar year of procedure 2008-2010, 2011-2013, 2014-2016, and 2017-2020. RESULTS: We identified 6,097 patients undergoing TAVR with year-by-year increases in TAVR penetration rate. Over time, the age of the patients remained stable (2008-2010 median age 82 year [interquartile range (IQR) 77-86] vs 2017-2020 median age 81 years [IQR 77-85]). Moreover, there was an increase in male patients (2008-2010 49.9% vs 2017-2020 57.4%) and patients with diabetes (2008-2010 14.2% vs 2017-2020 19.2%). Conversely, a history of stroke (2008-2010 15.8% vs 2017-2020 13.1%), previous myocardial infarction (2008-2010 22.4% vs 2017-2020 10.0%), heart failure (2008-2010 40.5% vs 2017-2020 25.2%), and peripheral artery disease (2008-2010 14.8% vs 2017-2020 10.4) decreased among patients. CONCLUSIONS: TAVR utilization increased markedly in the years 2008-2020. Patients undergoing TAVR had less comorbidity over time while age remained stable. Thus, despite expanding to patients at lower surgical risk, TAVR is still offered mainly to older patients.