Long-Term Outcomes After Transcatheter Aortic Valve Implantation in Patients With Chronic Inflammatory Disease

• Published in: Journal of the American Heart Association Vol. 13; no. 5; p. e032250
• Main Authors: Brunner, Stephanie, Covtun, Olga, Moccetti, Federico, Loretz, Lucca, Bossard, Matthias, Attinger-Toller, Adrian, Cuculi, Florim, Wolfrum, Mathias, Kurmann, Reto, Toggweiler, Stefan
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 05.03.2024; Wiley
• Subjects: Aged; Aged, 80 and over; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - surgery; Atrial Fibrillation - complications; Chronic Disease; chronic inflammatory disease; Female; Heart Valve Prosthesis; Humans; long‐term outcome; Male; Original Research; Registries; Risk Factors; TAVI; TAVR; Transcatheter Aortic Valve Replacement; Treatment Outcome; chronic inflammatory disease; long‐term outcome; TAVR; TAVI
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.123.032250

Chronic inflammatory disease (CID) accelerates atherosclerosis and the development of aortic stenosis. Data on long-term outcomes after transcatheter aortic valve implantation (TAVI) in those patients are missing. The aim of this study was to investigate the clinical long-term outcomes of patients with and without autoimmune-related CID undergoing TAVI for the treatment of severe aortic stenosis. From a prospective registry, consecutive patients with TAVI were included. Baseline clinic and imaging data (echocardiographic and computed tomography) were analyzed. Long-term (up to 5 years) clinical and echocardiographic outcomes were studied. Of 1000 consecutive patients (mean age 81±6 years, 46% female), 107 (11%) had CID; the most frequent entities included polymyalgia rheumatica (31%) and rheumatoid arthritis (28%). Patients with CID were predominantly female (60% versus 44%, =0.002) and more often had pulmonary disorders (21% versus 13%, =0.046) and atrial fibrillation (32% versus 20%, =0.003). The presence of CID was associated with a higher rate of postinterventional infection (5% versus 1%, =0.007) and further emerged as a risk factor for rehospitalization for bleeding or infection (hazard ratio, 1.93 and 1.62, respectively). Premature valve degeneration, endocarditis, and all-cause mortality were not increased among patients with CID. This real-world analysis found that patients with CID undergoing TAVI were associated with a higher risk of postinterventional infectious complications and rehospitalization due to infection. However, valve durability and survival seem not to differ between patients with TAVI with versus without CID.