Comparison of transcatheter to surgical aortic valve implantation in high risk patients : a nationwide study in France
| Autor: | Jean-François Obadia, Stéphanie Polazzi, Léa Pascal, Antoine Duclos, Xavier Armoiry |
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| Přispěvatelé: | Matériaux, ingénierie et science [Villeurbanne] (MATEIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), ONERA - The French Aerospace Lab [Toulouse], ONERA, Département d'information médicale, Hospices Civils de Lyon (HCL)-Université de Lyon |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Aortic valve
proportional hazards model clinical outcome heart failure morbidity high risk patient 030204 cardiovascular system & hematology [SPI.MAT]Engineering Sciences [physics]/Materials cause of death FIne and Gray competing risk model hazard ratio 0302 clinical medicine Aortic valve replacement Risk of mortality Medicine 030212 general & internal medicine Cause of death adult Hazard ratio hospitalization cost longitudinal study health care cost risk assessment cohort analysis 3. Good health aged female medicine.anatomical_structure priority journal Cardiology France cerebrovascular accident Cardiology and Cardiovascular Medicine Cohort study Pulmonary and Respiratory Medicine medicine.medical_specialty heart infarction Article 03 medical and health sciences male statistical analysis Internal medicine follow up aortic valve replacement controlled study human intermethod comparison outcome assessment propensity score transcatheter aortic valve implantation hospital mortality business.industry Proportional hazards model EuroSCORE aortic valve disease medicine.disease major clinical study multicenter study confidence interval pacemaker implantation Surgery business RD RC |
| Zdroj: | Journal of Thoracic and Cardiovascular Surgery Journal of Thoracic and Cardiovascular Surgery, Elsevier, 2018, 156 (3), pp.1017-1025.e4. ⟨10.1016/j.jtcvs.2018.02.092⟩ |
| ISSN: | 0022-5223 1097-685X |
| Popis: | cited By 3; International audience; Objective: To compare the clinical outcomes and direct costs at 5 years between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) using real-world evidence. Methods: We performed a nationwide longitudinal study using data from the French Hospital Information System from 2009 to 2015. We matched, inside hospitals, 2 cohorts of adults who underwent TAVI or SAVR during 2010 on propensity score based on patient characteristics. Outcomes analysis included mortality, morbidity, and total costs and with a maximum 60-month follow-up. Clinical outcomes were compared between cohorts using hazard ratios (HRs) estimated from a Cox proportional hazards model for all-cause death, and from Fine and Gray's competing risk model for morbidity. Results: Based on a cohort of 1598 patients (799 in each group) from 27 centers, a higher risk of death was observed after 1 year with TAVI compared with SAVR (16.8% vs 12.8%, respectively; HR, 1.33; 95% confidence interval [CI], 1.02-1.72) and was sustained up to 5 years (52.4% vs 37.2%; HR, 1.56; 95% CI, 1.33-1.84). At 5 years, the risk of stroke was increased (HR, 1.64; 95% CI, 1.07-2.54) as was myocardial infarction (HR, 2.30; 95% CI, 1.12-4.69) and pacemaker implantation (HR, 2.40; 95% CI, 1.81-3.17) after TAVI. The hospitalization costs per patient at 5 years were €69,083 after TAVI and €55,687 after SAVR (P |
| Databáze: | OpenAIRE |
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