Survival and cause of death after transcatheter aortic valve replacement as compared to an age- and sex-matched background population

AIMS: This study aimed to assess survival and causes of death in a real-world TAVR population as compared to an age- and sex-matched background population.

METHODS AND RESULTS: Each aortic stenosis (AS) patient treated with TAVR in Eastern Denmark between 2007 and 2014 (n=617) was matched with 25 age- and sex-matched controls (n=15,425) randomly drawn from the general Danish population. In the total TAVR population, early mortality (≤90 days) was significantly higher (hazard ratio [HR] 3.90 [2.82-5.39]; p<0.001) as compared to its background population, driven mainly by cardiovascular (CV) mortality. Late mortality (>90 days) was not different between the TAVR and background population (HR 1.16 [0.96-1.40]; p=0.126), causes of death being mainly non-CV. In subgroup analysis, the HR for late mortality was 0.98, 1.11, and 1.90 for the low-, intermediate-, and high-risk TAVR groups, respectively, as compared to their matched controls and 1.04, 1.45, and 1.52 for the high gradient, paradoxical low-flow low-gradient (P-LFLG), and classical LFLG (C-LFLG) groups, respectively, as compared to their controls.

CONCLUSIONS: In general, AS patients who survive the first three months after TAVR have a similar survival to their matched controls. Relative survival benefit is the highest in low-to-intermediate risk AS patients with a high transvalvular gradient.