Older transcatheter aortic valve replacement (TAVR) patients are more likely to die or experience a stroke up to a year after the procedure, according to new research published in JACC: Cardiovascular Interventions.
“TAVR has emerged as the preferred treatment modality for a broad spectrum of elderly patients with symptomatic, severe aortic stenosis,” wrote lead author Adrian Attinger-Toller, MD, an interventional cardiologist at University and Hospital Fribourg in Switzerland, and colleagues. “Advanced age itself is a driving factor during heart team discussions, and elderly patients are likely to be referred for less invasive TAVR interventions. However, the available research provides conflicting evidence with regard to the clinical benefit of TAVR in very elderly patients.”
The study’s authors focused on data from more than 7,000 TAVR patients who were treated at one of 15 participating hospitals in Switzerland. All patients were treated from February 2011 to June 2018.
The mean patient age was 82 years old, and 50.4% were men. While more than 4,000 patients were in their 80s at the time of the procedure, nearly 2,000 were in their 70s, 507 were in their 90s and more than 300 were in their 60s or younger.
The researchers found that most procedural characteristics were the same for all TAVR patients, though older patients were more likely to be discharged to a referring hospital or rehab facility after the procedure. Also, after making adjustments, increasing age was associated with increases mortality after 30 days and one year. Older patients were also associated with a higher likelihood of cerebrovascular accidents such as strokes or transient ischemic attack and pacemaker implantation.
Patients in their 90s had a mortality rate comparable to individuals from the same age bracket in the general population, the team added.
Click here to read the full study from JACC: Clinical Interventions.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.