Comparison of long-term mortality in patients who underwent transcatheter aortic valve replacement with or without anti-atherosclerotic therapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-06-08

AUTHORS

Kazuya Sasaki, Yusuke Watanabe, Ken Kozuma, Akihisa Kataoka, Hirofumi Hioki, Fukuko Nagura, Yashima Fumiaki, Shinichi Shirai, Norio Tada, Masahiro Yamawaki, Toru Naganuma, Futoshi Yamanaka, Hiroshi Ueno, Minoru Tabata, Kazuki Mizutani, Kensuke Takagi, Masanori Yamamoto, Kentaro Hayashida

ABSTRACT

Atherosclerosis is a risk factor for both aortic stenosis (AS) and coronary artery disease. This study aimed to investigate whether anti-atherosclerotic therapy (AT), defined as the simultaneous use of antiplatelet agents, statins, and renin aldosterone system inhibitors, had long-term clinical benefits for patients who underwent transcatheter aortic valve replacement (TAVR). Between October 2013 and May 2017, 2518 patients (31% men; median age, 85 years) who underwent TAVR in 14 Japanese centers were divided into two groups: patients who were prescribed anti-atherosclerotic therapy (AT, n = 567) and patients who were not (no AT, n = 1951). The median follow-up period for this cohort was 693 days (interquartile range, 389–870 days). Compared to no AT group, AT group was associated with significantly lower 2-year all-cause mortality (11.7% vs. 16.5%; log-rank p = 0.002) and 2-year cardiovascular mortality rates (3.5% vs. 6.0%; log-rank p = 0.017). In a propensity-matched cohort (n = 495 each; median follow-up, 710 days [IQR, 394 − 896 days]), patients in AT group had a lower prevalence of 2-year cardiovascular mortality (3.8% vs. 6.2%, log-rank p = 0.024) than that in the no AT group. In the multivariate stepwise regression analysis, AT was a significant predictor of cardiovascular mortality (hazard ratio 0.45; 95% confidence interval 0.25–0.80; p = 0.007). AT may improve survival in post-TAVR patients. Future studies are necessary to identify an optimal treatment regimen to improve long-term outcomes after TAVR. More... »

PAGES

1892-1902

Journal

TITLE

Heart and Vessels

ISSUE

12

VOLUME

36

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-021-01873-4

DOI

http://dx.doi.org/10.1007/s00380-021-01873-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1138691033

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34101028


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17 schema:description Atherosclerosis is a risk factor for both aortic stenosis (AS) and coronary artery disease. This study aimed to investigate whether anti-atherosclerotic therapy (AT), defined as the simultaneous use of antiplatelet agents, statins, and renin aldosterone system inhibitors, had long-term clinical benefits for patients who underwent transcatheter aortic valve replacement (TAVR). Between October 2013 and May 2017, 2518 patients (31% men; median age, 85 years) who underwent TAVR in 14 Japanese centers were divided into two groups: patients who were prescribed anti-atherosclerotic therapy (AT, n = 567) and patients who were not (no AT, n = 1951). The median follow-up period for this cohort was 693 days (interquartile range, 389–870 days). Compared to no AT group, AT group was associated with significantly lower 2-year all-cause mortality (11.7% vs. 16.5%; log-rank p = 0.002) and 2-year cardiovascular mortality rates (3.5% vs. 6.0%; log-rank p = 0.017). In a propensity-matched cohort (n = 495 each; median follow-up, 710 days [IQR, 394 − 896 days]), patients in AT group had a lower prevalence of 2-year cardiovascular mortality (3.8% vs. 6.2%, log-rank p = 0.024) than that in the no AT group. In the multivariate stepwise regression analysis, AT was a significant predictor of cardiovascular mortality (hazard ratio 0.45; 95% confidence interval 0.25–0.80; p = 0.007). AT may improve survival in post-TAVR patients. Future studies are necessary to identify an optimal treatment regimen to improve long-term outcomes after TAVR.
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24 Japanese centers
25 agents
26 aldosterone system inhibitors
27 analysis
28 anti-atherosclerotic therapy
29 antiplatelet agents
30 aortic stenosis
31 aortic valve replacement
32 artery disease
33 atherosclerosis
34 benefits
35 cardiovascular mortality
36 cardiovascular mortality rates
37 cause mortality
38 center
39 clinical benefit
40 cohort
41 comparison
42 coronary artery disease
43 days
44 disease
45 factors
46 follow
47 future studies
48 group
49 inhibitors
50 long-term clinical benefit
51 long-term mortality
52 long-term outcomes
53 low prevalence
54 median follow
55 mortality
56 mortality rate
57 multivariate stepwise regression analysis
58 optimal treatment regimen
59 outcomes
60 patients
61 period
62 post-TAVR patients
63 predictors
64 prevalence
65 propensity-matched cohort
66 rate
67 regimen
68 regression analysis
69 replacement
70 risk factors
71 significant predictors
72 simultaneous use
73 statins
74 stenosis
75 stepwise regression analysis
76 study
77 survival
78 system inhibitors
79 therapy
80 transcatheter aortic valve replacement
81 treatment regimen
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83 valve replacement
84 schema:name Comparison of long-term mortality in patients who underwent transcatheter aortic valve replacement with or without anti-atherosclerotic therapy
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