Statin therapy for patients with aortic stenosis who underwent transcatheter aortic valve implantation: A report from a Japanese multicentre registry

Fumiaki Yashima, Masahiko Hara, Taku Inohara, Masahiro Jinzaki, Hideyuki Shimizu, Keiichi Fukuda, Makoto Tanaka, Masanori Yamamoto, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Masahiro Yamawaki, Norio Tada, Futoshi Yamanaka, Kazuki Mizutani, Hiroshi Ueno, Minoru Tabata, Kensuke Takagi, Kentaro Hayashida

研究成果: Article査読

抄録

Objective Data on statin for patients with aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI) are limited. The present study aimed to evaluate the impact of statin on midterm mortality of TAVI patients. Design Observational study. Setting This study included patients with AS from a Japanese multicentre registry who underwent TAVI. Participants The overall cohort included 2588 patients (84.4±5.2 years); majority were women (69.3%). The Society of Thoracic Surgeons risk score was 6.55% (IQR 4.55%-9.50%), the Euro II score was 3.74% (IQR 2.34%-6.02%) and the Clinical Frailty Scale score was 3.9±1.2. Interventions We classified patients based on statin at admission and identified 936 matched pairs after propensity score matching. Primary and secondary outcome measures The outcomes were all-cause and cardiovascular mortality. Results The median follow-up was 660 days. Statin at admission was associated with a significant reduction in all-cause mortality (adjusted HR (aHR) 0.76, 95% CI 0.58 to 0.99, p=0.04) and cardiovascular mortality (aHR 0.64, 95% CI 0.42 to 0.97, p=0.04). In the octogenarians, statin was associated with significantly lower all-cause mortality (aHR 0.87, 95% CI 0.75 to 0.99, p=0.04); however, the impact in the nonagenarians appeared to be lower (aHR 0.84, 95% CI 0.62 to 1.13, p=0.25). Comparing four groups according to previous coronary artery disease (CAD) and statin, there was a significant difference in all-cause mortality, and patients who did not receive statin despite previous CAD showed the worst prognosis (aHR 1.33, 95% CI 1.12 to 1.57 (patients who received statin without previous CAD as a reference), p<0.01). Conclusions Statin for TAVI patients will be beneficial even in octogenarians, but the benefits may disappear in nonagenarians. In addition, statin will be essential for TAVI patients with CAD. Further research is warranted to confirm and generalise our findings since this study has the inherent limitations of an observational study and included only Japanese patients.

本文言語English
論文番号e044319
ジャーナルBMJ open
11
6
DOI
出版ステータスPublished - 2021 6 11

ASJC Scopus subject areas

  • 医学(全般)

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