Table 3.
Clinical outcomes in mechanical AVR versus bioprosthetic AVR for patients aged 50 to 70 years (n=1,580)
| Outcomesa) | Original | IPTW | |||||||
|---|---|---|---|---|---|---|---|---|---|
|
|
|
||||||||
| No. of events (rate) | OR or HR (95% CI) | p-value | No. of events (rate) | OR or HR/sHR (95% CI) | p-value | ||||
|
|
|
||||||||
| Mechanical AVR (N=984) | Bioprosthetic AVR (N=596) | Mechanical AVR (N=984) | Bioprosthetic AVR (N=596) | ||||||
| Early outcomes, no. (%) | |||||||||
| Early death | 9 (0.9) | 10 (1.7) | 1.85 (0.75–4.58) | 0.177 | 1.0 | 1.1 | 1.19 (0.42–3.33) | 0.741 | |
| Bleeding requiring exploration | 35 (3.6) | 27 (4.5) | 1.29 (0.77–2.15) | 0.330 | 3.7 | 3.8 | 1.05 (0.60–1.83) | 0.856 | |
| LCOS requiring MCSb) | 11 (1.1) | 11 (1.8) | 1.66 (0.72–3.86) | 0.230 | 1.1 | 1.2 | 1.08 (0.40–2.87) | 0.885 | |
| Stroke | 25 (2.5) | 22 (3.7) | 1.47 (0.82–2.63) | 0.190 | 2.7 | 2.7 | 1.01 (0.53–1.95) | 0.966 | |
| New onset dialysis | 10 (1.0) | 6 (1.0) | 0.99 (0.36–2.74) | 0.985 | 1.3 | 0.6 | 0.48 (0.15–1.59) | 0.233 | |
| Sternal wound infection | 12 (1.2) | 8 (1.3) | 1.10 (0.45–2.71) | 0.830 | 1.2 | 1.3 | 1.14 (0.45–2.90) | 0.787 | |
| Overall outcomes, no. (%/PY) | |||||||||
| All-cause death | 220 (2.0) | 167 (3.6) | 2.15 (1.74–2.64) | <0.001 | 2.3 | 2.9 | 1.39 (1.07–1.80) | 0.014 | |
| Stroke | 106 (1.3) | 32 (0.9) | 0.63 (0.43–0.94) | 0.025 | 1.4 | 0.5 | 0.44 (0.28–0.67) | <0.001 | |
| Anticoagulation-related bleeding | 119 (1.5) | 31 (0.8) | 0.55 (0.37–0.82) | 0.004 | 1.5 | 0.6 | 0.35 (0.23–0.53) | <0.001 | |
| Operated valve endocarditis | 22 (0.3) | 14 (0.4) | 1.28 (0.66–2.53) | 0.464 | 0.2 | 0.4 | 1.31 (0.61–2.82) | 0.486 | |
| AV reintervention | 41 (0.5) | 35 (0.9) | 2.35 (1.48–3.74) | <0.001 | 0.4 | 0.8 | 6.14 (3.17–11.93) | <0.001 | |
| SVD | 0 | 17 (0.5) | 0.0 | 0.4 | |||||
| Endocarditis | 16 (0.2) | 13 (0.3) | 0.2 | 0.3 | |||||
| Pannus | 15 (0.2) | 1 (0.0) | 0.2 | 0.0 | |||||
| Others | 10 (0.1) | 4 (0.1) | 0.1 | 0.1 | |||||
| Readmission due to cardiac cause | 256 (3.6) | 118 (3.5) | 0.96 (0.77–1.20) | 0.710 | 3.6 | 3.1 | 1.30 (0.86–1.97) | 0.210 | |
Values are presented as number (%) or number (% per patient-year) unless otherwise indicated. Early outcomes are presented as ORs. Overall outcomes are presented as HRs or sHRs.
AVR, aortic valve replacement; IPTW, inverse-probability-of-treatment weighting; OR, odds ratio; HR, hazard ratio; CI, confidence interval; sHR, sub-distributional hazard ratio; LCOS, low cardiac output syndrome; MCS, mechanical circulatory support; PY, patient-year; AV, aortic valve; SVD, structural valve deterioration.
a)Outcomes captured using the primary diagnosis during a visit to the emergency department or using any primary or secondary diagnosis during hospitalization. b)Included extracorporeal membrane oxygenation, intra-aortic balloon pump, and ventricular assist device.