经导管主动脉瓣植入术后的死亡率和发病率与年龄和性别匹配的对照人群的比较:来自SWEDEHEART登记的一项基于人群的研究。

IF 4.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Maria Lachonius, Susanne J Nielsen, Kok Wai Giang, Jenny Backes, Henrik Bjursten, Henrik Hagström, Stefan James, Magnus Settergren, Kristofer Skoglund, Anders Jeppsson, Pétur Pétursson
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引用次数: 0

摘要

与普通人群相比,经导管主动脉瓣植入术(TAVI)后死亡和主要不良心血管事件(MACE)风险的数据缺乏。因此,我们评估了65岁及以上TAVI患者的全因死亡和MACE风险,并与年龄和性别匹配的对照人群进行了比较。方法:2014 - 2020年共纳入5 924例TAVI患者和10 928例匹配的对照组(平均年龄分别为82.1,SD 6.0和81.9,SD 6.1)。使用SWEDEHEART登记处和四个强制性国家登记处收集数据。使用Cox回归模型评估与全因死亡率和MACE风险的关系。结果:随访期间,TAVI患者死亡1410例(23.8%),对照组死亡2115例(19.4%)。中位随访时间分别为1.9年(IQR 0.9-3.3)。TAVI患者的粗死亡率和MACE风险均高于对照组(风险比分别为1.27[95%可信区间(CI): 1.19-1.36]和1.44 [95% CI: 1.35-1.53])。校正后,TAVI患者的死亡率和MACE风险均较低(校正危险比(aHR)分别为0.77 [95% CI: 0.71-0.84]和0.90 [95% CI: 0.83-0.98])。结论:在调整合并症后,与年龄和性别匹配的对照组相比,TAVI患者的死亡风险较低。这些研究结果表明,TAVI患者的高合并症负担对TAVI后死亡率和MACE风险有很强的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mortality and morbidity after transcatheter aortic valve implantation compared to an age- and sex-matched control population: a population-based study from the SWEDEHEART registry.

Introduction: Data are lacking about the risk for death and major adverse cardiovascular events (MACE) after transcatheter aortic valve implantation (TAVI), compared to the general population. Therefore, we assessed the risk for all-cause death and MACE after TAVI in patients aged 65 years and older, in comparison to an age- and sex-matched control population.

Methods and results: In total, 5924 TAVI patients and 10 928 matched controls [mean age 82.1, standard deviation (SD) 6.0, and 81.9, SD 6.1, respectively] were included from 2014 to 2020. The SWEDEHEART registry and four mandatory national registers were used to collect data. Cox regression models were used to assess the association with all-cause mortality and MACE risk. In total, 1410 (23.8%) of the TAVI patients and 2115 (19.4%) controls died during the follow-up period. Median follow-up was 1.9 years (inter quartile range 0.9-3.3) respectively. The crude mortality and MACE risks were higher in TAVI patients than in controls {hazard ratios 1.27 [95% Confidence interval (CI): 1.19-1.36] and HR 1.44 (95% CI: 1.35-1.53), respectively}. After adjustment, there was a lower risk for both mortality and MACE in TAVI patients [adjusted hazard ratio (aHR) 0.77 (95% CI: 0.71-0.84) and aHR 0.90 (95% CI: 0.83-0.98), respectively].

Conclusion: After adjustments for comorbidities, the mortality risk was lower in TAVI patients, compared with an age- and sex-matched control population. These findings suggest that the high burden of comorbidities in TAVI patients has a strong impact on the risk for mortality and MACE after TAVI.

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来源期刊
CiteScore
9.40
自引率
3.80%
发文量
76
期刊介绍: European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.
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