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

Stephanie Brunner1, Olga Covtun1, Federico Moccetti1

  • 1Heart Center Lucerne, Cardiology Division, Luzerner Kantonsspital Lucerne Switzerland.

Journal of the American Heart Association
|February 23, 2024
PubMed

Insights

Patients with chronic inflammatory disease (CID) undergoing transcatheter aortic valve implantation (TAVI) face increased infection risks but show similar survival and valve durability compared to those without CID.

Area of Science:

  • Cardiology
  • Rheumatology
  • Infectious Diseases

Background:

  • Chronic inflammatory disease (CID) is linked to accelerated atherosclerosis and aortic stenosis.
  • Long-term outcomes after transcatheter aortic valve implantation (TAVI) in CID patients are not well-documented.

Purpose of the Study:

  • To investigate the clinical long-term outcomes of patients with and without autoimmune-related CID undergoing TAVI for severe aortic stenosis.

Main Methods:

  • Prospective registry analysis of 1000 consecutive TAVI patients.
  • Assessment of baseline and long-term (up to 5 years) clinical and echocardiographic outcomes.
  • Comparison of outcomes between patients with and without CID, including specific inflammatory conditions.

Main Results:

  • 11% of TAVI patients had CID (e.g., polymyalgia rheumatica, rheumatoid arthritis).
  • CID patients were more often female and had higher rates of pulmonary disorders and atrial fibrillation.
  • CID was associated with increased post-TAVI infection rates and rehospitalization for bleeding or infection.

Conclusions:

  • TAVI in CID patients is linked to a higher risk of post-procedural infectious complications and infection-related rehospitalization.
  • Valve durability and overall survival appear unaffected by the presence of CID post-TAVI.
Abstract

Keywords:
TAVITAVRchronic inflammatory diseaselong‐term outcome

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