Our Experience with Transcatheter Aortic Valve Replacement Medication Outcomes from 2013 to 2016

Area of Science:

• Cardiology
• Gerontology
• Pharmacology

Background:

• Aortic stenosis (AS) is a degenerative valve disease common in older adults, linked to calcification and scarring.
• Hemodynamic factors and atherosclerosis-like processes contribute to AS pathology.
• Transcatheter aortic valve replacement (TAVR) is a key treatment for severe AS.

Purpose of the Study:

• To evaluate the short and long-term clinical outcomes of risk factor reduction post-TAVR.
• To assess the effectiveness of specific medications in reducing mortality after TAVR.
• To compare outcomes of various medication regimens following TAVR.

Main Methods:

• Retrospective analysis of data from Charleston Area Medical Center.
• Utilized STATA 11.4 for data examination and Cox proportional hazards model for significance testing.
• Analyzed medications including aspirin, clopidogrel, beta-blockers, ACE inhibitors, statins, and anticoagulants post-TAVR.

Main Results:

• Clopidogrel monotherapy demonstrated the lowest mortality rate at three years (hazard ratio 0.4845, p=0.027).
• Statins showed the second-lowest mortality rate at one year (hazard ratio 0.7299, p=0.215).
• Both clopidogrel and statins consistently showed lower hazard/risk of death compared to other regimens.

Conclusions:

• Post-TAVR therapy with clopidogrel and statins may trend towards reduced mortality.
• Aspirin and clopidogrel alone did not significantly increase mortality compared to alternative anticoagulation.
• Further research into clopidogrel and statin use post-aortic valve revascularization is warranted.