L Fauchier1, A Bisson2, J Herbert3, T Lacour2, T Bourguignon4, C Saint Etienne2, A Bernard2, P Deharo5, L Bernard6, D Babuty2. 1. Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France. Electronic address: laurent.fauchier@univ-tours.fr. 2. Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France. 3. Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA7505, Université de Tours, France; Service d'information Médicale, d'épidémiologie et d'économie de la santé, Centre Hospitalier Universitaire et Faculté de Médecine, EA7505, Université de Tours, France. 4. Service de Chirurgie Cardiaque, Centre Hospitalier Universitaire et Faculté de Médecine, Université de Tours, France. 5. Département de Cardiologie, Centre Hospitalier Universitaire Timone, Inserm, Inra, C2VN, France et Faculté de Médecine, Université Aix-Marseille, Marseille, France. 6. Service de Médecine interne et Maladies Infectieuses, Centre Hospitalier Universitaire et Faculté de Médecine, Université de Tours, France.
Abstract
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR) in aortic stenosis (AS). Infective endocarditis (IE) in patients with prosthetic heart valves is associated with significant morbidity and mortality. Data on the incidence, risk factors, and outcomes of IE after TAVI are conflicting. We evaluated these issues in patients with percutaneous TAVI vs. isolated surgical AVR (SAVR) at a nationwide level. METHODS: Based on the administrative hospital discharge database, the study collected information for all patients with aortic stenosis treated with AVR in France between 2010 and 2018. RESULTS: A total of 47 553 patients undergoing TAVI and 60 253 patients undergoing isolated SAVR were identified. During a mean follow-up of 2.0 years (median (25th to 75th percentile) 1.2 (0.1-3.4) years), the incidence rates of IE were 1.89 (95% confidence interval (CI) 1.78-2.00) and 1.40 (95% CI 1.34-1.46) events per 100 person-years in unmatched TAVI and SAVR patients, respectively. In 32 582 propensity-matched patients (16 291 with TAVI and 16 291 with SAVR), risk of IE was not different in patients treated with TAVI vs. SAVR (incidence rates of IE 1.86 (95% CI 1.70-2.04) %/year vs 1.71 (95% CI 1.58-1.85) %/year respectively, relative risk (RR) 1.09, 95% CI 0.96-1.23). In these matched patients, total mortality was higher in TAVI patients with IE (43.0% 95% CI 37.3-49.3) than in SAVR patients with IE (32.8% 95% CI 28.6-37.3; RR 1.32, 95% CI 1.08-1.60). DISCUSSION: In a nationwide cohort of patients with AS, treatment with TAVI was associated with a risk of IE similar to that following SAVR. Mortality was higher for patients with IE following TAVI than for those with IE following SAVR.
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR) in aortic stenosis (AS). Infective endocarditis (IE) in patients with prosthetic heart valves is associated with significant morbidity and mortality. Data on the incidence, risk factors, and outcomes of IE after TAVI are conflicting. We evaluated these issues in patients with percutaneous TAVI vs. isolated surgical AVR (SAVR) at a nationwide level. METHODS: Based on the administrative hospital discharge database, the study collected information for all patients with aortic stenosis treated with AVR in France between 2010 and 2018. RESULTS: A total of 47 553 patients undergoing TAVI and 60 253 patients undergoing isolated SAVR were identified. During a mean follow-up of 2.0 years (median (25th to 75th percentile) 1.2 (0.1-3.4) years), the incidence rates of IE were 1.89 (95% confidence interval (CI) 1.78-2.00) and 1.40 (95% CI 1.34-1.46) events per 100 person-years in unmatched TAVI and SAVR patients, respectively. In 32 582 propensity-matched patients (16 291 with TAVI and 16 291 with SAVR), risk of IE was not different in patients treated with TAVI vs. SAVR (incidence rates of IE 1.86 (95% CI 1.70-2.04) %/year vs 1.71 (95% CI 1.58-1.85) %/year respectively, relative risk (RR) 1.09, 95% CI 0.96-1.23). In these matched patients, total mortality was higher in TAVI patients with IE (43.0% 95% CI 37.3-49.3) than in SAVR patients with IE (32.8% 95% CI 28.6-37.3; RR 1.32, 95% CI 1.08-1.60). DISCUSSION: In a nationwide cohort of patients with AS, treatment with TAVI was associated with a risk of IE similar to that following SAVR. Mortality was higher for patients with IE following TAVI than for those with IE following SAVR.
Authors: Vassili Panagides; Mohamed Abdel-Wahab; Norman Mangner; Eric Durand; Nikolaj Ihlemann; Marina Urena; Costanza Pellegrini; Francesco Giannini; Piotr Scislo; Zenon Huczek; Martin Landt; Vincent Auffret; Jan Malte Sinning; Asim N Cheema; Luis Nombela-Franco; Chekrallah Chamandi; Francisco Campelo-Parada; Erika Munoz-Garcia; Howard C Herrmann; Luca Testa; Won-Keun Kim; Helene Eltchaninoff; Lars Søndergaard; Dominique Himbert; Oliver Husser; Azeem Latib; Hervé Le Breton; Clement Servoz; Philippe Gervais; David Del Val; Axel Linke; Lisa Crusius; Holger Thiele; David Holzhey; Josep Rodés-Cabau Journal: Clin Res Cardiol Date: 2022-03-09 Impact factor: 6.138
Authors: Consuelo Fernández-Avilés; Juan C Castillo; Gloria Heredia; Adriana Resúa; Rafael González; Manuel Pan; Manuel Anguita Journal: Cardiol J Date: 2021-11-17 Impact factor: 3.487
Authors: Anthony J Buckley; Richard Tanner; Brian Armstrong; Saber Hassan; Barbara Moran; Jamie Byrne; Susan Groarke; Ronan Margey; Ivan P Casserly Journal: Ir J Med Sci Date: 2022-05-03 Impact factor: 2.089
Authors: Joop J P Kouijzer; Daniëlle J Noordermeer; Wouter J van Leeuwen; Nelianne J Verkaik; Kirby R Lattwein Journal: Front Cell Dev Biol Date: 2022-10-03
Authors: Sophia L Alexis; Aaqib H Malik; Isaac George; Rebecca T Hahn; Omar K Khalique; Karthik Seetharam; Deepak L Bhatt; Gilbert H L Tang Journal: J Am Heart Assoc Date: 2020-08-08 Impact factor: 5.501
Authors: Jonas Lanz; Michael J Reardon; Thomas Pilgrim; Stefan Stortecky; G Michael Deeb; Stanley Chetcuti; Steven J Yakubov; Thomas G Gleason; Jian Huang; Stephan Windecker Journal: J Am Heart Assoc Date: 2021-09-28 Impact factor: 5.501