The rise of transcatheter aortic valve replacement (TAVR) as a go-to treatment for severe aortic stenosis (AS) has been perhaps the biggest story in all of interventional cardiology over the last decade. A new research letter in Circulation: Cardiovascular Interventions, a journal of the American Heart Association, provides even more evidence of this ongoing trend.[1]
“The introduction of TAVR provided a treatment option for inoperable patients, improved access to treatment across the spectrum of risk, raised awareness for AS, and fueled strategies for timely intervention,” wrote first author Christoph Ryffel, MD, a cardiologist with Bern University Hospital in Switzerland, and colleagues. “We investigated the effect of expansion of TAVR on mortality due to AS at a population level in high-income countries.”
Ryffel et al. examined TAVR utilization from 2014 to 2019 in a total of 21 high-income countries: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, Netherlands, New Zealand, Norway, Poland, Portugal, Spain, Sweden, Switzerland, the United Kingdom and the United States.
Overall, the annual number of TAVR procedures per 100,000 patients 65 years old or older “significantly increased” from 24 per 100,000 in 2014 to 79 per 100,000 in 2019.
The authors also explored mortality date from those same countries. Age-adjusted all-cause mortality per 100,000 patients 65 years old or older dropped from 4,060 per 100,000 in 2010 to 3,800 per 100,000 in 2017. Age-adjusted mortality due to AS among the same patient population dropped from 43.4 per 100,000 in 2015 to 41.5 per 100,000 in 2019.
One key takeaway from the group’s research was that countries with larger increases in TAVR utilization were associated with a drop in age-adjusted mortality due to AS among elderly patients.
“These observations suggest that the diffusion of TAVR favorably affected mortality in elderly patients with AS,” the authors wrote. “Reduction of geographic and demographic variability in TAVR utilization may further decrease mortality due to AS.”
Click here to access the full research letter.
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.