All-cause mortality not drastically different between TAVR vs. surgery

ANAHEIM, Calif. —The comparative all-cause mortality between 3 and 5 years among patients undergoing transcatheter vs. surgical aortic valve replacement is not statistically significant, according to an analysis presented at the American Heart Association Scientific Sessions.

According to an abstract from Garly Rushler Saint Croix, MD, from Jackson Memorial Hospital, Miami, and colleagues, 2-year comparative benefits and harms of TAVR vs. surgical AVR for patients with aortic stenosis at high surgical risk show no statistical significance up to 2 years, but there were previously no substantial data beyond 3 years.

Saint Croix and colleagues conducted a literature review of randomized controlled trials with at least 3 years of follow-up to assess the outcomes of TAVR and surgical AVR in this patient set.

Eight databases containing articles from 2000 to 2017 were analyzed for the study.

A total of 748 eligible publications were found via the database, highlighting three relevant randomized controlled trials with 6,321 patients.

Of the three trials, two evaluated all-cause mortality at 3 years and one at 5 years.

The analysis showed no significant differences in the outcomes beyond 3 years in terms of all-cause mortality (OR = 1.29; 95% CI, 0.82-2.03).

Stroke rates among both groups were not statistically different (OR = 0.92; 95% CI, 0.67- 1.27), but there was a higher rate of pacemaker implantations for the TAVR group (OR = 2.73; 95% CI, 2.05, 3.64).

“This study confirms that all-cause mortality beyond 3 and up to 5 years in TAVR vs. [surgical] AVR is not statistically significant,” Saint Croix and colleagues wrote in the abstract. – by Dave Quaile

Reference:

Saint Croix GR, et al. Abstract 4165. Presented at: American Heart Association Scientific Sessions; Nov. 11-15, 2017; Anaheim, Calif.

Disclosure: Saint Croix reports no relevant financial disclosures.