Prognosis of Type 2 Myocardial Infarction Patients Implanted With a Prophylactic Defibrillator (from the Very-High-Rate Registry)

authors

• Deharo Pierre
• Bisson Arnaud
• Herbert Julien
• Lacour Thibaud
• Saint Etienne Christophe
• Grammatico-Guillon Leslie
• Porto Alizée
• Collart Frederic
• Bourguignon Thierry
• Cuisset Thomas
• Fauchier Laurent
• Garcia Rodrigue
• Boveda Serge
• Defaye Pascal
• Sadoul Nicolas
• Narayanan Kumar
• Perier Marie-Cécile
• Klug Didier
• Leclercq Christophe
• Babuty Dominique
• Bordachar Pierre
• Gras Daniel
• Deharo Jean-Claude
• Piot Olivier
• Providencia Rui
• Marijon Eloi
• Algalarrondo Vincent
• Theron Alexis
• David Charlotte
• André Clémentine
• Pierre Bertrand
• Bernard Anne
• Angoulvant Denis
• Clementy Nicolas

abstract

Background: Two competing transcatheter aortic valve replacement (TAVR) technologies are currently available. Head-to-head comparisons of the relative performances of these 2 devices have been published. However, long-term clinical outcome evaluation remains limited by the number of patients analyzed, in particular, for recent-generation devices. Methods: Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients treated with a TAVR device commercialized in France between 2014 and 2018. Propensity score matching was used for the analysis of outcomes during follow-up. The objective of this study was to analyze the outcomes of TAVR according to Sapien 3 balloon-expandable (BE) versus Evolut R self-expanding TAVR technology at a nationwide level in France. Results: A total of 31 113 patients treated with either Sapien 3 BE or Evolut R self-expanding TAVR were found in the database. After matching on baseline characteristics, 20 918 patients were analyzed (10 459 in each group with BE or self-expanding valves). During follow-up (mean [SD], 358 [384]; median [interquartile range], 232 [10–599] days), BE TAVR was associated with a lower yearly incidence of all-cause death (relative risk, 0.88; corrected P =0.005), cardiovascular death (relative risk, 0.82; corrected P =0.002), and rehospitalization for heart failure (relative risk, 0.84; corrected P <0.0001). BE TAVR was also associated with lower rates of pacemaker implantation after the procedure (relative risk, 0.72; corrected P <0.0001). Conclusions: On the basis of the largest cohort available, we observed that Sapien 3 BE valves were associated with lower rates of all-cause death, cardiovascular death, rehospitalization for heart failure, and pacemaker implantation after a TAVR procedure.

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