Attizzani Guilherme F, Ohno Yohei, Latib Azeem, Petronio Anna Sonia, Giannini Cristina, Ettori Federica, Fiorina Claudia, Bedogni Francesco, Brambilla Nedy, Bruschi Giuseppe, Colombo Paola, Presbitero Patrizia, Fiorilli Rosario, Poli Arnaldo, Barbanti Marco, Colombo Antonio, Tamburino Corrado
Department of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
Department of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
Am J Cardiol. 2016 Oct 1;118(7):1024-30. doi: 10.1016/j.amjcard.2016.07.018. Epub 2016 Jul 28.
Scarce data are available on the impact of age on transcatheter aortic valve implantation (TAVI) outcomes. We therefore, analyzed 1,845 consecutive patients from 9 Italian centers who underwent TAVI with the Corevalve Revalving System from September 2007 to March 2014; patients were dichotomized according to their age in the date of the procedure, as follows: 75 to 85 years old and >85 years old. End points were defined according to Valve Academic Research Consortium definitions. In-hospital, 30-day, and 1-year clinical and echocardiographic data were available for 100% of the patients included. Propensity matching was performed. Procedural success rates were high (>94%) and comparable between groups. Although worse baseline renal function was observed in the older group, the incidence of acute kidney injury after procedure was comparable (17.1% and 17.4%, respectively for the 75- to 85- and >85-year-old group, p = 0.877); importantly, >99% of acute kidney injury episodes in both groups were grades 1 and 2. Procedural complications rates were low without between-group differences. In-hospital death (3.7% and 4.6%, p = 0.379) and stroke/transient ischemic attack (1.9% and 1.9%, respectively, p = 0.960) were comparable. The 1-year death rates were 14.9% and 17.2% (p = 0.197) in the 75- to 85- and >85-year-old group, respectively. Cardiovascular death was observed in 7.8% and 7% (p = 0.542), while stroke/transient ischemic attack was demonstrated in 5.2% and 4.4% (p = 0.496), respectively. Results were sustained after propensity matching. In conclusion, advanced age did not negatively impact the outcomes of TAVI through 1-year after procedure.
关于年龄对经导管主动脉瓣植入术（TAVI）结局的影响，现有数据稀少。因此，我们分析了2007年9月至2014年3月期间来自意大利9个中心的1845例连续接受Corevalve Revalving系统TAVI的患者；根据手术日期时的年龄将患者分为两组，如下：75至85岁和大于85岁。终点根据瓣膜学术研究联盟的定义确定。纳入的患者100%可获得住院、30天和1年的临床及超声心动图数据。进行了倾向匹配。手术成功率很高（>94%），且两组之间相当。虽然老年组的基线肾功能较差，但术后急性肾损伤的发生率相当（75至85岁组和大于85岁组分别为17.1%和17.4%，p = 0.877）；重要的是，两组中>99%的急性肾损伤事件为1级和2级。手术并发症发生率较低，且组间无差异。住院死亡率（3.7%和4.6%，p = 0.379）和中风/短暂性脑缺血发作（分别为1.9%和1.9%，p = 0.960）相当。75至85岁组和大于85岁组的1年死亡率分别为14.9%和17.2%（p = 0.197）。心血管死亡分别为7.8%和7%（p = 0.542），而中风/短暂性脑缺血发作分别为5.2%和4.4%（p = 0.496）。倾向匹配后结果依然成立。总之，高龄在术后1年内并未对TAVI结局产生负面影响。
