PMID- 30989700
OWN - NLM
STAT- MEDLINE
DCOM- 20191217
LR  - 20210109
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 42
IP  - 6
DP  - 2019 Jun
TI  - Long-term outcomes in Japanese nonagenarians undergoing transcatheter aortic 
      valve implantation: A multi-center analysis.
PG  - 605-611
LID - 10.1002/clc.23183 [doi]
AB  - BACKGROUND AND HYPOTHESIS: Japan is an aging society, and the number of 
      nonagenarians with severe aortic stenosis undergoing transcatheter aortic valve 
      implantation (TAVI) is increasing, but their outcomes have not been determined 
      fully. METHODS: We prospectively enrolled 767 consecutive patients who underwent 
      TAVI in three Japanese institutions. Clinical characteristics and outcomes of 
      nonagenarians (n = 94) were evaluated and compared with those of patients aged 
      <90 years (n = 673). RESULTS: Prevalence of New York Heart Association (NYHA) 
      class III/IV was not different between the two groups. Preoperative risk scores 
      were significantly higher in nonagenarians compared with those in 
      non-nonagenarians, whereas the Clinical Frailty Scale was not different. 
      Thirty-day mortality tended to be higher (P = .06) and major vascular 
      complication was significantly higher in nonagenarians than in non-nonagenarians 
      (P < .05), but 3-year mortality was equivalent between the two groups. Even after 
      adjustment for covariates, female sex (hazard ratio, 0.41; 95% confidence 
      interval: 0.25-0.67), body mass index (0.87, 0.80-0.94), and NYHA class III/IV 
      (1.84, 1.06-3.29) were associated with all-cause mortality. Age >/= 90 years was 
      not associated with all-cause mortality. CONCLUSIONS: TAVI could be undertaken 
      safely and effectively in nonagenarians, who had acceptable long-term results 
      compared with those for younger patients, although careful attention should be 
      paid to major vascular complication.
CI  - (c) 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
FAU - Yokoyama, Hiroaki
AU  - Yokoyama H
AUID- ORCID: 0000-0001-6452-6413
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
AD  - Department of Cardiology, Hirosaki University Graduate School of Medicine, 
      Hirosaki, Japan.
FAU - Tobaru, Tetsuya
AU  - Tobaru T
AD  - Department of Cardiology, Kawasaki Saiwai Hospital, Kawasaki, Japan.
FAU - Muto, Yuki
AU  - Muto Y
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Hagiya, Kenichi
AU  - Hagiya K
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Higuchi, Ryosuke
AU  - Higuchi R
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Saji, Mike
AU  - Saji M
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Takamisawa, Itaru
AU  - Takamisawa I
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Shimizu, Jun
AU  - Shimizu J
AD  - Department of Anesthesiology, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Takanashi, Shuichiro
AU  - Takanashi S
AD  - Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Takayama, Morimasa
AU  - Takayama M
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
FAU - Tomita, Hirofumi
AU  - Tomita H
AD  - Department of Cardiology, Hirosaki University Graduate School of Medicine, 
      Hirosaki, Japan.
FAU - Tamura, Harutoshi
AU  - Tamura H
AD  - Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School 
      of Medicine, Yamagata, Japan.
FAU - Doi, Shinichiro
AU  - Doi S
AD  - Department of Cardiovascular Medicine, Juntendo University School of Medicine, 
      Tokyo, Japan.
FAU - Okazaki, Shinya
AU  - Okazaki S
AD  - Department of Cardiovascular Medicine, Juntendo University School of Medicine, 
      Tokyo, Japan.
FAU - Isobe, Mitsuaki
AU  - Isobe M
AD  - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20190423
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Age Factors
MH  - Aged, 80 and over
MH  - Aortic Valve/*surgery
MH  - Aortic Valve Stenosis/mortality/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Japan/epidemiology
MH  - Male
MH  - Postoperative Complications/*epidemiology
MH  - Prospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Transcatheter Aortic Valve Replacement/*methods
MH  - Treatment Outcome
PMC - PMC6553359
OTO - NOTNLM
OT  - TAVI
OT  - long-term outcome
OT  - nonagenarians
COIS- The authors declare no potential conflict of interests.
EDAT- 2019/04/17 06:00
MHDA- 2019/12/18 06:00
PMCR- 2019/04/23
CRDT- 2019/04/17 06:00
PHST- 2019/03/11 00:00 [received]
PHST- 2019/04/13 00:00 [accepted]
PHST- 2019/04/17 06:00 [pubmed]
PHST- 2019/12/18 06:00 [medline]
PHST- 2019/04/17 06:00 [entrez]
PHST- 2019/04/23 00:00 [pmc-release]
AID - CLC23183 [pii]
AID - 10.1002/clc.23183 [doi]
PST - ppublish
SO  - Clin Cardiol. 2019 Jun;42(6):605-611. doi: 10.1002/clc.23183. Epub 2019 Apr 23.