Patients aged between 65 and 80 with aortic valve stenosis have better long-term survival rates when treated with surgical aortic valve replacement (SAVR) compared to transcatheter aortic valve implantation (TAVI), according to recent real-world data from Italy.
Study Overview
A retrospective analysis was conducted using administrative health databases from Lombardy and Puglia regions in Italy. The study focused on individuals aged 65 to 80 who underwent either SAVR or TAVI procedures between 2018 and 2021. Researchers employed propensity-matching techniques to ensure comparable groups, examining outcomes over a follow-up period ranging from two to five years. The primary measure of success was mortality rates, alongside cardiac and non-cardiac events.
Key Findings
In both regions studied, SAVR was associated with significantly lower mortality rates compared to TAVI. Specifically, in Lombardy, mortality stood at 24.6% for SAVR patients versus 47.2% for those receiving TAVI. Similarly, in Puglia, SAVR resulted in an 18.1% mortality rate compared to 44.1% among TAVI recipients. These results diverge from previous randomized controlled trials, which suggested that TAVI could be as effective or even superior to SAVR in similar populations.
- Real-world data challenges the preference for TAVI in the 65-80 age group.
- SAVR demonstrates superior long-term survival in this demographic.
- Discrepancies between American and European guidelines affect treatment decisions.
- Patient selection criteria may need refinement to optimize outcomes.
The contrasting outcomes between this study and controlled trials highlight the importance of considering real-world settings when determining treatment strategies. It suggests that SAVR could still be the preferred option for patients under 80 years unless specific contraindications for surgery exist.
Healthcare providers should carefully evaluate patient profiles and consider SAVR as a viable option for a broader age range. Further research may be necessary to reconcile these findings with existing clinical trial data, ultimately guiding more tailored and effective treatment decisions for aortic valve stenosis.
These findings provide valuable insights for cardiologists and surgeons in making informed decisions about aortic valve replacement methods. By prioritizing SAVR in the 65-80 demographic, medical professionals can potentially improve survival rates and optimize patient outcomes based on real-world evidence.
Implementing guidelines that reflect real-world data may enhance treatment efficacy and patient safety. Additionally, ongoing monitoring and analysis of patient outcomes will be crucial in refining therapeutic approaches and ensuring the best possible care for individuals suffering from aortic valve stenosis.
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