PMID- 38134979 OWN - NLM STAT- MEDLINE DCOM- 20240202 LR - 20240202 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 213 DP - 2024 Feb 15 TI - Long-Term Survival and Quality of Life Following Transcatheter Aortic Valve Replacement in Nonagenarians. PG - 140-145 LID - S0002-9149(23)01415-7 [pii] LID - 10.1016/j.amjcard.2023.12.031 [doi] AB - Transcatheter aortic valve replacement (TAVR) has emerged as a successful treatment option for severe aortic stenosis. However, the long-term outcomes of TAVR in nonagenarians is lacking. We aimed to examine the long-term mortality and quality of life in nonagenarians after TAVR. This is a multicenter, retrospective analysis on patients with severe aortic stenosis who underwent TAVR. Patients were divided into 2 groups: nonagenarians (age >/=90 years) and age <90 years. The Kansas City cardiomyopathy questionnaire (KCCQ) and New York Heart Association (NYHA) scores were compared before and after TAVR. All-cause mortality was compared between both groups at 30 days, 1 year, and 5 years after TAVR using the Cox proportional hazard model. A total of 6,896 patients were included, of whom 591 were nonagenarians. Nonagenarians had a higher Society of Thoracic Surgeons perioperative risk of mortality (8.1 +/- 4.6% vs 5.4 +/- 4.2%, p <0.001) before TAVR. Both groups were similar in KCCQ and NYHA scores at baseline. At 1 year after TAVR, there was no significant difference in improvement in the KCCQ overall score between those aged <90 years and nonagenarians (-4.76, 95% confidence interval [CI] -11.4 to 1.9, p = 0.161). Similarly, there was no statistically significant difference in improvement in NYHA class between the 2 groups at 1 year (odds ratio 1.07, 95% CI 0.85 to 1.25), p = 0.526). The unadjusted 30-day (3.2% vs 2.7%, hazard ratio 1.11, 95% CI 0.70 to 1.80, p = 0.667) and 5-year (28.0% vs 26.6%, hazard ratio 1.05, 95% CI 0.89 to 1.24, p = 0.60) all-cause mortality were similar between the 2 groups. In conclusion, this study demonstrates an excellent long-term mortality rate at 5 years after TAVR in nonagenarians, comparable to patients younger than 90 years. There is a significant and enduring improvement in functional status in nonagenarians, observed up to 1 year after TAVR. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Madanat, Luai AU - Madanat L AD - William Beaumont University Hospital, Corewell Health East, Michigan. FAU - Allam, Mohamed AU - Allam M AD - William Beaumont University Hospital, Corewell Health East, Michigan. FAU - Khalili, Houman AU - Khalili H AD - Florida Atlantic University, Boca Raton, Florida; Memorial Cardiovascular Institute, Hollywood, Florida. FAU - Rabah, Andrew AU - Rabah A AD - Oakland University William Beaumont School of Medicine, Rochester, Michigan. FAU - Tariq, Rehan AU - Tariq R AD - Oakland University William Beaumont School of Medicine, Rochester, Michigan. FAU - Zamzam, Mazen AU - Zamzam M AD - Oakland University William Beaumont School of Medicine, Rochester, Michigan. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AD - Universite Laval, Quebec, Canada; Quebec Heart and Lung Institute, Quebec, Canada. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Bern University Hospital, Bern, Switzerland. FAU - Okuno, Taishi AU - Okuno T AD - Bern University Hospital, Bern, Switzerland. FAU - Elmariah, Sammy AU - Elmariah S AD - University of San Francisco, San Francisco, California. FAU - Pibarot, Philippe AU - Pibarot P AD - Universite Laval, Quebec, Canada; Quebec Heart and Lung Institute, Quebec, Canada. FAU - Abbas, Amr E AU - Abbas AE AD - William Beaumont University Hospital, Corewell Health East, Michigan; Oakland University William Beaumont School of Medicine, Rochester, Michigan. Electronic address: Amr.Abbas@corewellhealth.org. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20231221 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged, 80 and over MH - Humans MH - *Transcatheter Aortic Valve Replacement MH - Quality of Life MH - Nonagenarians MH - Treatment Outcome MH - Retrospective Studies MH - *Aortic Valve Stenosis MH - Aortic Valve/surgery MH - Risk Factors OTO - NOTNLM OT - KCCQ score OT - NYHA score OT - TAVR OT - long-term mortality OT - nonagenarians OT - quality of life COIS- Declaration of competing interest Amr Abbas, Philippe Pibarot, and Sammy Elmariah have received research grants and consulting fees from Edwards life Sciences. Philippe Pibarot and Sammy Elmariah have received research grants from Medtronic. Thomas Pilgrim received grants from Boston Scientific and Pilgrim, received speaker fees from Biotronik, consultancy fees from HighLife SAS, and proctor fees from Boston Scientific and Medtronic. Taishi Okuno reports speaker fees from Abbott. The remaining authors have no competing interest to declare. EDAT- 2023/12/23 12:42 MHDA- 2024/02/02 06:43 CRDT- 2023/12/22 19:28 PHST- 2023/10/10 00:00 [received] PHST- 2023/11/16 00:00 [revised] PHST- 2023/12/17 00:00 [accepted] PHST- 2024/02/02 06:43 [medline] PHST- 2023/12/23 12:42 [pubmed] PHST- 2023/12/22 19:28 [entrez] AID - S0002-9149(23)01415-7 [pii] AID - 10.1016/j.amjcard.2023.12.031 [doi] PST - ppublish SO - Am J Cardiol. 2024 Feb 15;213:140-145. doi: 10.1016/j.amjcard.2023.12.031. Epub 2023 Dec 21.