Janine Biermann1,2, Martin Horack3, Philipp Kahlert4, Steffen Schneider3, Georg Nickenig5, Ralf Zahn3, Jochen Senges3, Raimund Erbel4, Jürgen Wasem6, Till Neumann4. 1. Clinic of Cardiology, University Hospital Essen, Essen, Germany. janine.biermann@medman.uni-due.de. 2. Institute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany. janine.biermann@medman.uni-due.de. 3. Stiftung IHF, Foundation IHF, Institute of Myocardial Infarction Research, Ludwigshafen, Germany. 4. Clinic of Cardiology, University Hospital Essen, Essen, Germany. 5. Department of Medicine II, Cardiology, University Hospital Bonn, Bonn, Germany. 6. Institute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
Abstract
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) has proven a survival benefit in patients with severe symptomatic aortic stenosis (AS). Recently published data from the German TAVI registry reported a 1-year mortality rate of 19.9 %. However, there are limited data for the effect of TAVI on quality of life (QoL), especially in real life settings. METHODS: The German TAVI registry was launched to evaluate safety, effectiveness and QoL of TAVI in daily clinical routine. We analyzed health-related QoL, using the EQ-5D questionnaire. RESULTS: Quality-of-life data were eligible for 460 patients who survived 12 months after TAVI (82.5 ± 6.0 years; 32.2 % men). At baseline, QoL (EQ-5D-index: 0.63 ± 0.26) was markedly depressed, but significantly improved 30 days and 12 months (0.67 ± 0.24; 0.70 ± 0.24; p < 0.0001) after TAVI procedure. In addition, the visual analogue health scale, recording the patient's self-rated health, significantly (p < 0.0001) increased from 42.0 ± 15.9 % at baseline to 57.0 ± 17.2 % (30 days) and 57.7 ± 19.6 % (12 months). A lower EQ-5D-index at baseline, a percutaneous transfemoral/transaxillar TAVI procedure, and indications other than frailty for TAVI were determinants for an improved QoL 1 year after TAVI. CONCLUSIONS: Among patients with AS, TAVI resulted in meaningful improvements in QoL. This benefit was present shortly after TAVI and maintained for at least 1 year. Different gains in QoL regarding patient-subgroups and determinants for improved QoL could give further impetus for patient selection.
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) has proven a survival benefit in patients with severe symptomatic aortic stenosis (AS). Recently published data from the German TAVI registry reported a 1-year mortality rate of 19.9 %. However, there are limited data for the effect of TAVI on quality of life (QoL), especially in real life settings. METHODS: The German TAVI registry was launched to evaluate safety, effectiveness and QoL of TAVI in daily clinical routine. We analyzed health-related QoL, using the EQ-5D questionnaire. RESULTS: Quality-of-life data were eligible for 460 patients who survived 12 months after TAVI (82.5 ± 6.0 years; 32.2 % men). At baseline, QoL (EQ-5D-index: 0.63 ± 0.26) was markedly depressed, but significantly improved 30 days and 12 months (0.67 ± 0.24; 0.70 ± 0.24; p < 0.0001) after TAVI procedure. In addition, the visual analogue health scale, recording the patient's self-rated health, significantly (p < 0.0001) increased from 42.0 ± 15.9 % at baseline to 57.0 ± 17.2 % (30 days) and 57.7 ± 19.6 % (12 months). A lower EQ-5D-index at baseline, a percutaneous transfemoral/transaxillar TAVI procedure, and indications other than frailty for TAVI were determinants for an improved QoL 1 year after TAVI. CONCLUSIONS: Among patients with AS, TAVI resulted in meaningful improvements in QoL. This benefit was present shortly after TAVI and maintained for at least 1 year. Different gains in QoL regarding patient-subgroups and determinants for improved QoL could give further impetus for patient selection.
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