Clinical Outcomes Following Transcatheter?Aortic Valve Replacement?in?Asian Population

Yoon, Sung-Han; Ahn, Jung-Min; Hayashida, Kentaro; Watanabe, Yusuke; Shirai, Shinichi; Kao, Hsien-Li; Yin, Wei-Hsian; Lee, Michael Kang-Yin; Tay, Edgar; Araki, Motoharu; Yamanaka, Futoshi; Arai, Takahide; Lin, Mao-Shin; Park, Jun-Bean; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Muramatsu, Toshiya; Hanyu, Michiya; Kozuma, Ken; Kim, Hyo-Soo; Saito, Shigeru; Park, Seung-Jung
JACC. Cardiovascular interventions
2016May ; 9 ( 9 ) :926-33.
저자 상세정보
Yoon, Sung-Han - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Ahn, Jung-Min - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Hayashida, Kentaro - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Watanabe, Yusuke - Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Shirai, Shinichi - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Kao, Hsien-Li - Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Yin, Wei-Hsian - Division of Cardiology, Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan.
Lee, Michael Kang-Yin - Division of Cardiology, Queen Elizabeth Hospital, Kowloon, Hong Kong.
Tay, Edgar - Department of Cardiology, National University Heart Centre, Singapore.
Araki, Motoharu - Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan.
Yamanaka, Futoshi - Division of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan.
Arai, Takahide - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Lin, Mao-Shin - Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Park, Jun-Bean - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
Park, Duk-Woo - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Kang, Soo-Jin - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Lee, Seung-Whan - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Kim, Young-Hak - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Lee, Cheol Whan - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Park, Seong-Wook - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
Muramatsu, Toshiya - Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan.
Hanyu, Michiya - Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.
Kozuma, Ken - Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Kim, Hyo-Soo - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
Saito, Shigeru - Division of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan.
Park, Seung-Jung - Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea. Electronic address sjpark@amc.seoul.kr. CN - Asian TAVR Investigators
ABSTRACT
OBJECTIVES: This study describes the characteristics of a real-world Asian patient population treated with transcatheter aortic valve replacement (TAVR) and evaluates their clinical outcomes. BACKGROUND: No previously reported randomized or observational studies adequately assess the safety and efficacy of TAVR in an Asian population.

METHODS: The Asian TAVR registry is an international multicenter study that enrolled patients with aortic stenosis who underwent TAVR in Asian countries.

RESULTS: In total, 848 patients with mean STS score of 5.2 짹 3.8% were enrolled between March 2010 and September 2014 at 11 centers in 5 countries. The Edwards Sapien or Medtronic CoreValve was implanted in 64.7% and 35.3% of patients, respectively. The procedural success rate was 97.5%. The 30-day and 1-year mortality rates were 2.5% and 10.8%, respectively. There was no difference in 1-year mortality between devices (Sapien: 9.4%; CoreValve: 12.2%; log-rank p?= 0.40). The rates of stroke, life-threatening bleeding, major vascular complications and acute kidney injury (stage 2 to 3) were 3.8%, 6.4%, 5.0% and 3.3%, respectively. Moderate or severe paravalvular leakage was significantly more common with the CoreValve than Sapien (14.4% vs. 7.3%; p?= 0.001). According to the multivariate model, a higher STS score, lower body mass index, New York Heart Association functional class III-IV symptoms, diabetes mellitus, prior cerebrovascular accident, low mean gradient at baseline, and moderate or severe paravalvular leakage were significantly associated with reduced survival.

CONCLUSIONS: Despite anatomical features of concern, the clinical outcomes of TAVR in our Asian population were?favorable in comparison with those of previously published trials and observational studies. (The Asian Transcatheter Aortic Valve Replacement Registry [Asian TAVR]; NCT02308150). CI - Copyright ??2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
keyword
Asia; aortic stenosis; transcatheter aortic valve replacement
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Clinical outcomes of TAVR using balloon-expandable or self-expanding prostheses in Asian populations were comparable with previous published trials and observational studies from Western countries.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
10.1016/j.jcin.2016.01.047.
KCD코드
ICD 03
건강보험코드