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Title: Transcatheter aortic valve implantation versus conservative management for severe aortic stenosis in real clinical practice
Authors: Takeji, Yasuaki
Taniguchi, Tomohiko
Morimoto, Takeshi
Saito, Naritatsu
Ando, Kenji
Shirai, Shinichi
Sakaguchi, Genichi
Arai, Yoshio
Fuku, Yasushi
Kawase, Yuichi
Komiya, Tatsuhiko
Ehara, Natsuhiko
Kitai, Takeshi
Koyama, Tadaaki
Watanabe, Shin
Watanabe, Hirotoshi  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-9443-5915 (unconfirmed)
Shiomi, Hiroki  kyouindb  KAKEN_id
Minamino-Muta, Eri
Matsuda, Shintaro
Yaku, Hidenori
Yoshikawa, Yusuke
Yamazaki, Kazuhiro
Kawatou, Masahide
Sakamoto, Kazuhisa
Tamura, Toshihiro
Miyake, Makoto
Sakaguchi, Hisashi
Murata, Koichiro
Nakai, Masanao
Kanamori, Norio
Izumi, Chisato
Mitsuoka, Hirokazu
Kato, Masashi
Hirano, Yutaka
Inada, Tsukasa
Nagao, Kazuya
Mabuchi, Hiroshi
Takeuchi, Yasuyo
Yamane, Keiichiro
Tamura, Takashi
Toyofuku, Mamoru
Ishii, Mitsuru
Inoko, Moriaki
Ikeda, Tomoyuki
Ishii, Katsuhisa
Hotta, Kozo
Jinnai, Toshikazu
Higashitani, Nobuya
Kato, Yoshihiro
Inuzuka, Yasutaka
Morikami, Yuko
Minatoya, Kenji
Kimura, Takeshi
Issue Date: 26-Sep-2019
Publisher: Public Library of Science (PLoS)
Journal title: PLOS ONE
Volume: 14
Issue: 9
Thesis number: e0222979
Abstract: Background: Transcatheter aortic valve implantation (TAVI) is criticized by some as an expensive treatment in super-elder patients with limited life expectancy. However, there is a knowledge gap regarding the magnitude of clinical benefit provided by TAVI in comparison with conservative management in patients with severe aortic stenosis (AS) in real clinical practice, which would be important in the decision making for TAVI. Methods: We combined two independent registries, namely CURRENT AS and K-TAVI registries. CURRENT AS was a multicenter registry enrolling 3815 consecutive patients with severe AS irrespective to treatment modalities between January 2003 and December 2011. K-TAVI was a multicenter, prospective registry including 449 consecutive patients with severe AS, who underwent TAVI with SAPIEN XT balloon-expandable valves between October 2013 and June 2016. In these 2 registries, 449 patients received TAVI and 894 patients were managed with conservative strategy. We conducted propensity score matching and finally obtained a cohort of 556 patients (278 patients for each group) for the analysis. The primary outcome measures were all-cause death and heart failure (HF) hospitalization at 2-year. Results: The cumulative 2-year incidences of all-cause death and HF hospitalization were significantly lower in the TAVI group than in the conservative group (16.8% versus 36.6%, P<0.001, and 10.7% versus 37.2%, P<0.001). After adjusting the residual confounders, TAVI reduced the risks of all-cause death (HR, 0.46; 95%CI, 0.32–0.69; P = 0.0001) and HF hospitalizations (HR, 0.25; 95%CI, 0.16–0.40; P<0.0001) compared with conservative strategy. There was no difference in the cumulative incidence of non-cardiovascular death between the 2 groups. Conclusions: TAVI in the early Japanese experience was associated with striking risk reduction for all-cause death as well as HF hospitalization as compared with the historical cohort of patients with severe AS who were managed conservatively just before introduction of TAVI in Japan.
Description: 竹治, 泰明
谷口, 智彦
森本, 剛
齋藤, 成達
安藤, 献児
白井, 伸一
新井, 善雄
坂口, 元一
福, 康志
川瀬, 裕一
小宮, 達彦
江原, 夏彦
北井, 豪
小山, 忠明
渡邉, 真
渡部, 宏俊
塩見, 紘樹
南野-牟田, 恵里
松田, 真太郎
夜久, 英憲
芳川, 裕亮
山﨑, 和裕
川東, 正英
坂本, 和久
田村, 俊寛
三宅, 誠
阪口, 仁寿
村田, 耕一郎
中井, 真尚
泉, 知里
稲田, 司
竹内, 泰代
山根, 啓一郎
田村, 崇
豊福, 守
石井, 充
猪子, 森明
池田, 智之
石井, 克尚
堀田, 幸造
陣内, 俊和
東谷, 暢也
犬塚, 康孝
湊谷, 謙司
木村, 剛
Rights: © 2019 Takeji et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
URI: http://hdl.handle.net/2433/250054
DOI(Published Version): 10.1371/journal.pone.0222979
PubMed ID: 31557200
Appears in Collections:Journal Articles

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