Mortality rates higher for TAVR-treated patients with low ejection fraction

Patients who underwent transcatheter aortic valve replacement for severe aortic stenosis had higher 30-day and 1-year mortality rates if their ejection fraction was low when compared with those in the normal range.

 “Our study demonstrates for the first time that in patients with low [ejection fraction] undergoing TAVR, short- and long-term mortality were significantly higher when compared to patients with normal [ejection fraction],” the researchers wrote. “However, these patients exhibited a significant recovery of [ejection fraction], which started at discharge and was sustained in time.”

In the study, the researchers evaluated whether TAVR impacts short- and long-term mortality in a patients with LV ejection fraction (LVEF) <50%, along with the impact of TAVR on ejection fraction recovery in these patients.

The meta-analysis included 26 studies comprising 6,898 patients. Eligible participants underwent TAVR to treat severe aortic stenosis. All-cause and CV mortality at 30 days, 6 months and 1 year served as the primary outcome measures. Patients with low ejection fraction underwent a further meta-analysis to assess for changes in ejection fraction after TAVR.

Patients with low LVEF experienced significantly higher all-cause and CV mortality rates in the short- and long-term compared with patients in the normal LVEF group. For all-cause mortality, the HR was 0.13 (95% CI, 0.01-0.25) at 30 days and 0.25 (95% CI, 0.16-0.34) at 1 year for low LVEF compared with normal LVEF. Thirty-day CV mortality yielded similar results (HR=0.03; 95% CI, -0.31-0.36), as did 1-year CV mortality (HR=0.29; 95% CI, 0.12-0.45).

Additionally, patients in the low ejection fraction group experienced significant recovery in ejection fraction in the TAVR setting, a trend that began at hospital discharge and persisted through 1 year follow-up.

Source: www.healio.com