JACC. Cardiovascular interventions · 2016
Clinical Outcomes Following Transcatheter Aortic Valve Replacement in Asian Population.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Yoon Sung-Han, Ahn Jung-Min, Hayashida Kentaro, Watanabe Yusuke, Shirai Shinichi, Kao Hsien-Li, Yin Wei-Hsian, Lee Michael Kang-Yin, Tay Edgar, Araki Motoharu, Yamanaka Futoshi, Arai Takahide, Lin Mao-Shin, Park Jun-Bean, Park Duk-Woo, Kang Soo-Jin, Lee Seung-Whan, Kim Young-Hak, Lee Cheol Whan, Park Seong-Wook, Muramatsu Toshiya, Hanyu Michiya, Kozuma Ken, Kim Hyo-Soo, Saito Shigeru, Park Seung-Jung, Asian TAVR Investigators
Аннотация
OBJECTIVES: This study describes the characteristics of a real-world Asian patient population treated with transcatheter aortic valve replacement (TAVR) and evaluates their clinical outcomes.
BACKGROUND: No previously reported randomized or observational studies adequately assess the safety and efficacy of TAVR in an Asian population.
METHODS: The Asian TAVR registry is an international multicenter study that enrolled patients with aortic stenosis who underwent TAVR in Asian countries.
RESULTS: In total, 848 patients with mean STS score of 5.2 ± 3.8% were enrolled between March 2010 and September 2014 at 11 centers in 5 countries. The Edwards Sapien or Medtronic CoreValve was implanted in 64.7% and 35.3% of patients, respectively. The procedural success rate was 97.5%. The 30-day and 1-year mortality rates were 2.5% and 10.8%, respectively. There was no difference in 1-year mortality between devices (Sapien: 9.4%; CoreValve: 12.2%; log-rank p = 0.40). The rates of stroke, life-threatening bleeding, major vascular complications and acute kidney injury (stage 2 to 3) were 3.8%, 6.4%, 5.0% and 3.3%, respectively. Moderate or severe paravalvular leakage was significantly more common with the CoreValve than Sapien (14.4% vs. 7.3%; p = 0.001). According to the multivariate model, a higher STS score, lower body mass index, New York Heart Association functional class III-IV symptoms, diabetes mellitus, prior cerebrovascular accident, low mean gradient at baseline, and moderate or severe paravalvular leakage were significantly associated with reduced survival.
CONCLUSIONS: Despite anatomical features of concern, the clinical outcomes of TAVR in our Asian population were favorable in comparison with those of previously published trials and observational studies. (The Asian Transcatheter Aortic Valve Replacement Registry [Asian TAVR]; NCT02308150).
BACKGROUND: No previously reported randomized or observational studies adequately assess the safety and efficacy of TAVR in an Asian population.
METHODS: The Asian TAVR registry is an international multicenter study that enrolled patients with aortic stenosis who underwent TAVR in Asian countries.
RESULTS: In total, 848 patients with mean STS score of 5.2 ± 3.8% were enrolled between March 2010 and September 2014 at 11 centers in 5 countries. The Edwards Sapien or Medtronic CoreValve was implanted in 64.7% and 35.3% of patients, respectively. The procedural success rate was 97.5%. The 30-day and 1-year mortality rates were 2.5% and 10.8%, respectively. There was no difference in 1-year mortality between devices (Sapien: 9.4%; CoreValve: 12.2%; log-rank p = 0.40). The rates of stroke, life-threatening bleeding, major vascular complications and acute kidney injury (stage 2 to 3) were 3.8%, 6.4%, 5.0% and 3.3%, respectively. Moderate or severe paravalvular leakage was significantly more common with the CoreValve than Sapien (14.4% vs. 7.3%; p = 0.001). According to the multivariate model, a higher STS score, lower body mass index, New York Heart Association functional class III-IV symptoms, diabetes mellitus, prior cerebrovascular accident, low mean gradient at baseline, and moderate or severe paravalvular leakage were significantly associated with reduced survival.
CONCLUSIONS: Despite anatomical features of concern, the clinical outcomes of TAVR in our Asian population were favorable in comparison with those of previously published trials and observational studies. (The Asian Transcatheter Aortic Valve Replacement Registry [Asian TAVR]; NCT02308150).
Предметные рубрики MeSH
AgedAged, 80 and overAortic Valve StenosisAsiaAsian PeopleChi-Square DistributionFemaleHeart Valve ProsthesisHumansKaplan-Meier EstimateMaleMultivariate AnalysisPostoperative ComplicationsProportional Hazards ModelsProspective StudiesProsthesis DesignRegistriesRisk AssessmentRisk FactorsTime FactorsTranscatheter Aortic Valve ReplacementTreatment Outcome