Quality of Life 5 Years Following Transfemoral TAVR or SAVR in Intermediate Risk Patients.
JACC Cardiovasc Interv
; 17(8): 979-988, 2024 Apr 22.
Article
in En
| MEDLINE
| ID: mdl-38658126
ABSTRACT
BACKGROUND:
Symptomatic patients with severe aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR) sustain comparable improvements in health status over 5 years after transcatheter aortic valve replacement (TAVR) or SAVR. Whether a similar long-term benefit is observed among intermediate-risk AS patients is unknown.OBJECTIVES:
The purpose of this study was to assess health status outcomes through 5 years in intermediate risk patients treated with a self-expanding TAVR prosthesis or SAVR using data from the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial.METHODS:
Intermediate-risk patients randomized to transfemoral TAVR or SAVR in the SURTAVI trial had disease-specific health status assessed at baseline, 30 days, and annually to 5 years using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Health status was compared between groups using fixed effects repeated measures modelling.RESULTS:
Of the 1,584 patients (TAVR, n = 805; SAVR, n = 779) included in the analysis, health status improved more rapidly after TAVR compared with SAVR. However, by 1 year, both groups experienced large health status benefits (mean change in KCCQ-Overall Summary Score (KCCQ-OS) from baseline TAVR 20.5 ± 22.4; SAVR 20.5 ± 22.2). This benefit was sustained, albeit modestly attenuated, at 5 years (mean change in KCCQ-OS from baseline TAVR 15.4 ± 25.1; SAVR 14.3 ± 24.2). There were no significant differences in health status between the cohorts at 1 year or beyond. Similar findings were observed in the KCCQ subscales, although a substantial attenuation of benefit was noted in the physical limitation subscale over time in both groups.CONCLUSIONS:
In intermediate-risk AS patients, both transfemoral TAVR and SAVR resulted in comparable and durable health status benefits to 5 years. Further research is necessary to elucidate the mechanisms for the small decline in health status noted at 5 years compared with 1 year in both groups. (Safety and Efficacy Study of the Medtronic CoreValve® System in the Treatment of Severe, Symptomatic Aortic Stenosis in Intermediate Risk Subjects Who Need Aortic Valve Replacement [SURTAVI]; NCT01586910).Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Valve
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Aortic Valve Stenosis
/
Quality of Life
/
Severity of Illness Index
/
Heart Valve Prosthesis
/
Health Status
/
Recovery of Function
/
Femoral Artery
/
Transcatheter Aortic Valve Replacement
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
En
Journal:
JACC Cardiovasc Interv
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2024
Document type:
Article