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

document type

ART

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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