Surgical and transcatheter aortic valve replacement align survival with general population expectations: insights from standardized mortality ratios DOI Creative Commons

Marin Boute,

David De Azevedo, Christophe de Terwangne

et al.

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 12

Published: April 11, 2025

Background Comparative long-term survival outcomes between transcatheter (TAVR) and surgical (SAVR) aortic valve replacement remain debated. While randomized controlled trials support TAVR's non-inferiority, real-world data indicate the opposite. Comparing SAVR TAVR patients with matched reference populations may reduce bias from direct comparisons. We compared 5-year overall rates of SAVR, non-frail TAVR, frail those general population standards. Methods All who underwent bioprosthetic or at a tertiary hospital 2012 to 2021 were included. Based on intervention type Clinical Frailty Scale, divided into three groups: TAVR. Survival was individual-level age- sex-matched using standardized mortality ratios (SMRs). Results The cohort included 939 328 121 patients, mean ages 73.6, 85.3, 85.6 years, median EuroSCORE II values 1.9%, 4.0%, 5.2%, respectively. had comparable [SMR = 0.93 [0.76–1.14]; p 0.437 SMR 0.94 [0.76–1.15]; 0.468]. Conversely, faced 40% increased risk their 1.40 (1.04–1.88); 0.012]. Conclusions In both restore life expectancy For lower rate highlights frailty's important prognostic impact underlines ongoing challenge refining patient selection avoid futility.

Language: Английский

Surgical and transcatheter aortic valve replacement align survival with general population expectations: insights from standardized mortality ratios DOI Creative Commons

Marin Boute,

David De Azevedo, Christophe de Terwangne

et al.

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 12

Published: April 11, 2025

Background Comparative long-term survival outcomes between transcatheter (TAVR) and surgical (SAVR) aortic valve replacement remain debated. While randomized controlled trials support TAVR's non-inferiority, real-world data indicate the opposite. Comparing SAVR TAVR patients with matched reference populations may reduce bias from direct comparisons. We compared 5-year overall rates of SAVR, non-frail TAVR, frail those general population standards. Methods All who underwent bioprosthetic or at a tertiary hospital 2012 to 2021 were included. Based on intervention type Clinical Frailty Scale, divided into three groups: TAVR. Survival was individual-level age- sex-matched using standardized mortality ratios (SMRs). Results The cohort included 939 328 121 patients, mean ages 73.6, 85.3, 85.6 years, median EuroSCORE II values 1.9%, 4.0%, 5.2%, respectively. had comparable [SMR = 0.93 [0.76–1.14]; p 0.437 SMR 0.94 [0.76–1.15]; 0.468]. Conversely, faced 40% increased risk their 1.40 (1.04–1.88); 0.012]. Conclusions In both restore life expectancy For lower rate highlights frailty's important prognostic impact underlines ongoing challenge refining patient selection avoid futility.

Language: Английский

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