Long-Term Cause of Death in Patients Who Underwent Transcatheter Aortic Valve Implantation

Abstract

As our knowledge on treatment with transcatheter aortic valve implantation (TAVI) increases and more implantations are conducted, we need knowledge on how TAVI affects the end of life. Long-term causes of death remain sparsely described. The aim of the study was to examine differences in the cause of death according to time from TAVI. All patients who underwent TAVI in Denmark from 2008 to 2017 were matched on gender, age, and calendar year with controls from the background population (1:4). Mortality and the proportion of cardiovascular and noncardiovascular death was assessed at 1-year time points during follow-up. A total of 3,434 patients receiving TAVI and 13,672 controls were identified. The median follow-up was 2.67years for patients receiving TAVI and 2.90years for controls. Among patients receiving TAVI, 1,254 deaths (36.5%) were recorded, with 46.7% being from cardiovascular causes. The corresponding numbers for controls were 3,338 deaths (24.4%) and 27.2% being from cardiovascular causes. The proportion of cardiovascular deaths decreased from 53.8% in the first year after TAVI to 32.7% among those who died >7years from TAVI (p=0.008 for trend). For controls, no difference was seen in the proportion of cardiovascular death regardless of follow-up time. In conclusion, with data from nationwide registries, we provide results reassuring that patients with long-term survival from TAVI resemble the general public regarding the cause of death.