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. 2025 Jun 17:qcaf041.
doi: 10.1093/ehjqcco/qcaf041. Online ahead of print.

Poor outcome after transcatheter aortic valve implantation using the EuroQoL-5-dimension-5-level: insights from the FRANCE TAVI registry

Gaspard Suc  1 , Anne-Sophie Boureau  2 , Eric Durand  3 , Hakim Benamer  4 , Guillaume Cayla  5 , Delphine Béziau  2 , Vincent Richard  6 , Martine Gilard  7 , Hélène Eltchaninoff  3 , Bernard Iung  1   8 ; STOP-AS and FRANCE-TAVI investigators
Collaborators, Affiliations

Poor outcome after transcatheter aortic valve implantation using the EuroQoL-5-dimension-5-level: insights from the FRANCE TAVI registry

Gaspard Suc et al. Eur Heart J Qual Care Clin Outcomes. .

Abstract

Aims: Despite procedural success, certain patients fail to derive clinical benefit from transcatheter aortic valve implantation (TAVI). In a nationwide TAVI registry, we assessed the proportion of patients experiencing either a deterioration in quality of life (QoL) or death 1 year after TAVI, and the factors associated with these outcomes.

Methods and results: This prospective substudy of the FRANCE TAVI registry included patients enrolled between 2018 and 2019 who completed the EuroQoL-5-dimension-5-level (EQ-5D-5L) questionnaire at baseline and 1 year. Among the 3159 patients (median age 83 years), EQ-5D-5L visual analogue scale increased significantly from 60 (IQR 50-70) at baseline to 70 (IQR 50-80) at follow-up (P < 0.001). However, 459 patients (14.5%) experienced a deterioration in QoL, and 596 (18.9%) died within 1 year. According to a multivariable logistic model, factors significantly associated with poor outcome were frailty [OR 1.40, 95% confidence interval (CI) (1.08-1.83)], diabetes [OR 1.41, 95% CI (1.06-1.88)], chronic pulmonary disease [OR 1.55, 95% CI (1.09-2.20)], critical pre-operative status [OR 0.42, 95% CI (0.21-0.83)], left ventricular ejection fraction [OR 1.01, 95% CI (1.00-1.02)], mean aortic gradient at discharge [OR 0.97, 95% CI (0.95-1.00)], need for pacemaker implantation [OR 1.51, 95% CI (1.10-2.06)], anticoagulation therapy at discharge [OR 1.65, 95% CI (1.23-2.22)], and time to discharge [OR 1.04, 95% CI (1.01-1.07)].

Conclusion: Although TAVI improved overall QoL, 14.5% of patients experienced a deterioration in QoL and 18.9% died within 1 year. Predictors included baseline comorbidities and post-procedural factors (anticoagulation at discharge and time to discharge), which are largely unpredictable.

Keywords: Aortic stenosis; Comorbidities; Quality of life; Transcatheter aortic valve implantation.

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Conflict of interest statement

Conflict of interest: E.D. has received lecture fees from Edwards Lifesciences. H.B. has received consulting fees and lecture fees from Edwards Lifesciences, Medtronic, Terumo and General Electric. GC has received consulting fees from Edwards, Medtronic, Microport CRM and lecture fees from Amgen, AstraZeneca, Abbott, Bayer, Biotronik, Bristol-Myers Squibb, Edwards, Microport, Medtronic, Pfizer and Sanofi-Aventis. HE has received lecture fees and travel support from Edwards Lifesciences and was supported bu a Grants from Edwards Lifesciences and Medtronic for conducting the STOP-AS research program. All other authors have nothing to declare.

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