Affiliation:
1. Erasmus MC University Medical Center, Section of Geriatrics, Department of Internal Medicine, Rotterdam, The Netherlands
2. Erasmus MC University Medical Center, Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands
Abstract
Abstract
Background
Transcatheter aortic valve implantation (TAVI) brings symptom relief and improvement in health-related quality of life (HRQoL) in the majority of patients treated for symptomatic, severe aortic stenosis. However, there is a substantial group of patients that do not benefit from TAVI. The aim of this study is to investigate the impact of frailty on HRQoL 1 year after TAVI.
Methods
The TAVI Care & Cure Program is an ongoing, prospective, observational study including patients referred for TAVI to our institution. A comprehensive geriatric assessment was performed to evaluate existence of frailty using the Erasmus Frailty Score (EFS). HRQoL was assessed using the EQ-5D-5 L at baseline and 1 year after TAVI.
Results
239 patients underwent TAVI and completed HRQoL assessment 1 year after TAVI. Seventy (29.3%) patients were classified as frail (EFS ≥ 3). In non-frail patients, the EQ-5D-5 L index did not change (0.71(± 0.22) to 0.68(± 0.33) points, P = 0.22); in frail patients, the EQ-5D-5 L index decreased from 0.55(±0.26) to 0.44 points (±0.33) (P = 0.022). Frailty was an independent predictor of deteriorated HRQoL 1 year after TAVI (OR 2.24, 95% CI 1.07–4.70, P = 0.003). In frail patients, the absence of peripheral artery disease (OR 0.17, 95% 0.05–0.50, P = 0.001) and renal dysfunction (OR 0.13, 95% CI 0.04–0.41, P = <0.001) at baseline was associated with improved HRQoL 1 year after TAVI.
Conclusion
Frailty is associated with deterioration of HRQoL 1 year after TAVI. Notably, HRQoL did improve in frail patients with no peripheral arterial disease or renal impairment at baseline.
Publisher
Oxford University Press (OUP)
Subject
Geriatrics and Gerontology,Aging,General Medicine