776 A History of Cancer Does Not Predict Long Term Mortality in Patients With Severe Aortic Stenosis

Abstract

A history of cancer is incorporated into the surgical risk assessment of patients undergoing surgical aortic valve replacement through the Society for Thoracic Surgeons (STS) score. However, the prognostic significance of cancer in patients treated with transcatheter aortic valve replacement (TAVR) is unknown. As the cancer survivorship population increases, it is imperative to establish the efficacy and safety of TAVR in patients with severe symptomatic aortic stenosis (AS) and a history of malignancy. 483 patients with echocardiographic evidence of severe AS diagnosed between 2015 to 2019 were included. The proportion of patients with a HOC (cancer free survival of >5 years) was established from the medical records. The primary outcome was all-cause mortality. Mean age was 80±11 years and 71 (15.0%) had a HOC. Patients with a HOC were significantly older with a higher rate of cardiovascular risk factors (p value for all <0.05). Over a mean follow-up of 2.0±1.3 years, 103 (21.9%) patients died. Despite their greater comorbidity, a HOC did not predict long term mortality (HR 1.1, 95% CI 0.65-1.85). In patients with severe AS, a history of cancer was not associated with adverse long-term survival. As such, invasive management should be considered in all patients with severe AS, irrespective of their history of malignancy.