Table 1. Baseline patient characteristics.
| Entire cohort | Propensity score-matched cohort | |||||
|---|---|---|---|---|---|---|
| TAVI group | Conservative group | P-value | TAVI group | Conservative group | P-value | |
| (N = 449) | (N = 984) | (N = 278) | (N = 278) | |||
| Clinical characteristics | ||||||
| Age, *y | 85.2±5.3 | 82.1±9.1 | <0.0001 | 84.6±5.7 | 85.1±7.0 | 0.41 |
| ≥80 years† | 399 (89) | 644 (65) | <0.0001 | 233 (84) | 235 (85) | 0.82 |
| Men*,† | 161 (36) | 288 (29) | 0.01 | 80 (29) | 81 (29) | 0.93 |
| BMI, kg/m2 | 22.0±3.5 | 21.2±3.9 | 0.0001 | 21.4±3.5 | 21.8±3.9 | 0.24 |
| <22.0 kg/m2*,† | 235 (52) | 689 (70) | <0.0001 | 171(62) | 171 (62) | 1.00 |
| BSA, m2 | 1.43±0.2 | 1.41±0.2 | 0.07 | 1.40±0.2 | 1.41±0.2 | 0.72 |
| Hypertension* | 349 (78) | 717 (73) | 0.05 | 211 (76) | 211 (76) | 1.00 |
| Smoking* | 82 (18) | 173 (18) | 0.75 | 46 (17) | 47 (17) | 0.91 |
| Dyslipidemia | 220 (49) | 317 (32) | <0.0001 | 140 (50) | 105 (38) | 0.003 |
| Diabetes mellitus | 123 (27) | 206 (21) | 0.008 | 81 (29) | 61 (22) | 0.05 |
| On insulin therapy* | 15 (3.3) | 37 (3.8) | 0.69 | 10 (3.6) | 9 (3.2) | 0.82 |
| Prior MI* | 18 (4.0) | 129 (13) | <0.0001 | 13 (4.7) | 49 (18) | <0.0001 |
| Prior PCI | 126 (28) | 128 (13) | <0.0001 | 75 (27) | 46 (17) | 0.003 |
| Prior CABG | 49 (11) | 71 (7.2) | 0.02 | 27 (9.7) | 33 (12) | 0.41 |
| Prior heart surgery† | 88 (20) | 106 (11) | <0.0001 | 45 (16) | 41 (15) | 0.64 |
| Prior symptomatic stroke*,† | 55 (12) | 131 (13) | 0.58 | 30 (11) | 24 (8.6) | 0.39 |
| Atrial fibrillation or flutter* | 48 (11) | 257 (26) | <0.0001 | 31 (11) | 55 (20) | 0.005 |
| Aortic/peripheral vascular disease* | 71 (16) | 130 (13) | 0.19 | 45 (16) | 35 (13) | 0.23 |
| Serum creatinine, mg/dL* | 0.9 (0.7–1.2) | 0.9 (0.7–1.3) | 0.90 | 0.9 (0.7–1.2) | 1.0 (0.7–1.3) | 0.32 |
| >2mg/dL† | 15 (3.4) | 81 (8.2) | 0.0003 | 12 (4.3) | 11 (4.0) | 0.82 |
| Anemia*,† | 344 (77) | 621 (63) | <0.0001 | 200 (72) | 206 (74) | 0.61 |
| Malignancy*,† | 41 (9.1) | 114 (12) | 0.16 | 23 (8.3) | 19 (6.8) | 0.52 |
| Immunosuppressive therapy† | 21 (4.7) | 36 (3.7) | 0.37 | 11 (4.0) | 10 (3.6) | 0.82 |
| Chronic lung disease | 138 (31) | 109 (11) | <0.0001 | 72 (26) | 29 (10) | <0.0001 |
| moderate or severe*,† | 51 (11) | 44 (4.5) | <0.0001 | 16 (5.8) | 14 (5.0) | 0.71 |
| Coronary artery disease* | 194 (43) | 295 (30) | <0.0001 | 114 (41) | 100 (36) | 0.22 |
| STS score (PROM), % | 6.4 (4.5–9.3) | 5.1 (3.1–8.6) | <0.0001 | 6.4 (4.5–9.2) | 5.8 (4.0–9.5) | 0.13 |
| Etiology of aortic stenosis | ||||||
| Degenerative | 445 (99) | 916 (93) | <0.0001 | 275 (99) | 268 (96) | 0.22 |
| Congenital (unicuspid, bicuspid, or quadricuspid) | 2 (0.5) | 21 (2.1) | 1 (0.4) | 3 (1.1) | ||
| Rheumatic | 1 (0.2) | 43 (4.4) | 1 (0.4) | 5 (1.8) | ||
| Infective endocarditis | 0 (0) | 0 (0) | 0 (0) | 0 (0) | ||
| Other | 1 (0.2) | 4 (0.4) | 1 (0.4) | 2 (0.7) | ||
| Echocardiographic variables | ||||||
| Vmax, m/s | 4.7±0.7 | 4.1±1.0 | <0.0001 | 4.6±0.7 | 4.1±1.0 | <0.0001 |
| Vmax ≥5 m/s† | 154 (34) | 21 (21) | <0.0001 | 80 (29) | 67 (24) | 0.23 |
| Vmax ≥4 m/s* | 385 (86) | 526 (53) | <0.0001 | 236 (85) | 151 (54) | <0.0001 |
| Peak aortic PG, mmHg | 87±28 | 70±33 | <0.0001 | 84±26 | 72±35 | <0.0001 |
| Mean aortic PG, mmHg | 52±17 | 40±21 | <0.0001 | 51±17 | 42±22 | <0.0001 |
| AVA, cm2 | 0.62± 0.17 | 0.70±0.19 | <0.0001 | 0.62±0.18 | 0.68±0.19 | <0.0001 |
| AVA index, cm2/m2 | 0.44±0.12 | 0.51±0.14 | <0.0001 | 0.44±0.13 | 0.49±0.14 | <0.0001 |
| Eligibility for severe AS | ||||||
| Vmax >4 m/s or mean aortic PG >40 mmHg |
370 (82) | 505 (51) | <0.0001 | 225 (81) | 147 (53) | <0.0001 |
| AVA <1.0 cm2 alone with LVEF <50% |
20 (4.5) | 186 (19) | <0.0001 | 16 (5.8) | 42 (15) | 0.0002 |
| AVA <1.0 cm2 alone with LVEF ≥50% |
56 (12) | 283 (29) | <0.0001 | 36 (13) | 86 (31) | <0.0001 |
| LVDd, mm | 44±7 | 46 ± 7 | <0.0001 | 44±7 | 44 ± 7 | 0.99 |
| LVDs, mm | 29±6 | 31 ± 8 | <0.0001 | 29±7 | 30 ± 7 | 0.56 |
| LVEF, %* | 61±11 | 59 ± 15 | 0.005 | 60±12 | 61 ± 13 | 0.59 |
| <40%† | 21 (4.7) | 123 (13) | <0.0001 | 16 (5.8) | 14 (5.0) | 0.70 |
| <50% | 66 (15) | 259 (26) | <0.0001 | 50 (18) | 59 (21) | 0.35 |
| IVST in diastole, mm | 11±2 | 11 ± 2 | 0.13 | 11 ± 2 | 11 ± 2 | 0.81 |
| PWT in diastole, mm | 11±2 | 11 ± 2 | 0.46 | 11 ± 3 | 11 ± 2 | 0.55 |
| Any combined valvular disease (moderate or severe)*,† |
81 (18) | 509 (52) | <0.0001 | 71 (26) | 70 (25) | 0.92 |
| AR | 33 (7.4) | 234 (24) | <0.0001 | 29 (10) | 31 (11) | 0.80 |
| MS | 16 (3.6) | 39 (4.0) | 0.72 | 5 (1.8) | 14 (5.1) | 0.03 |
| MR | 33 (7.4) | 285 (29) | <0.0001 | 30 (11) | 43 (15) | 0.11 |
| TR | 27 (6.0) | 223 (23) | 0.0001 | 24 (8.7) | 34 (12) | 0.17 |
Categorical variables were presented as number (%), and continuous variables were presented as mean ± SD, or median with interquartile range.
*Potential independent variables selected for Cox proportional hazards models in the unmatched cohort
† Potential independent variables selected for logistic regression model to develop propensity score for the choice of TAVI.
Anemia was defined as serum hemoglobin <12g/dl for women or <13g/dl for men.
TAVI, transcatheter aortic valve implantation; BMI, body mass index; BSA, body surface area; MI, myocardial infarction; PCI percutaneous coronary intervention; CABG, coronary artery bypass grafting; HD, hemodialysis; STS, society of thoracic surgeons; PROM, predicted risk of mortality; Vmax, peak aortic jet velocity; PG, pressure gradient; AVA, aortic valve area; AS, aortic stenosis; LVDd, left ventricular end-diastolic diameter; LVDs, left ventricular end-systolic diameter; LVEF, left ventricular ejection fraction; LV, left ventricular; IVST, interventricular septum thickness; PWT, posterior wall thickness; AR, aortic regurgitation; MS, mitral stenosis; MR, mitral regurgitation; TR, tricuspid regurgitation.