The prospective, multicentre FRANCE-TAVI registry study included 12,804 patients with mean age of 82.8 years old (SE: ±0.07 years) and logistic Euroscore 17.8% (SE: ±0.1%),  to identify independent factors of long-term all-cause mortality and early BVD. The protocol defined BVD as an increased prosthetic gradient ≥10 mmHg or a new gradient ≥20 mmHg.

At a mean duration of follow-up of 495 days (SE: ±3.5 days), 11,469 participants were alive when discharged and received documented antithrombotic treatment. Thirty-three per cent (3836/11,469) of the participants had a history of AF, and a similar proportion of patients was on oral anticoagulation upon discharge. Twenty-two per cent (2,555/11,469) of patients received at least two echocardiographic evaluations and were thus eligible for the BVD assessment.

The registry showed that anticoagulation at discharge (adj. OR 0.54; CI, 0.35-0.82; p=0.005) and a non-femoral approach (adj. OR 0.53; CI, 0.28-1.02; p=0.049) were independent correlates of lower rates of BVD. Aspirin nor clopidogrel independently associated with mortality.

Male gender (adj. HR 1.63; CI, 1.44-1.84; p<0.001), a history of AF (adj. HR 1.41; CI, 1.23-1.62; p<0.001), and CKD (adj. HR 1.37; CI, 1.23-1.53; p<0.001) had the strongest independent correlation with mortality. CKD (adj. OR 1.46; CI, 1.03-2.08; p=0.034) and prosthesis size ≤23mm (adj. OR 3.43; CI, 2.41-4.89; p<0.001) correlated to higher risk of BVD.

Reference

Overtchouk P, et al. J Am Coll Cardiol. 2018; doi: 10.1016/j.jacc.2018.08.1045.