Long‐Term Outcomes After Transcatheter Aortic Valve Implantation in Patients With Chronic Inflammatory Disease

Abstract

Background Chronic inflammatory disease (CID) accelerates atherosclerosis and the development of aortic stenosis. Data on long‐term outcomes after transcatheter aortic valve implantation (TAVI) in those patients are missing. The aim of this study was to investigate the clinical long‐term outcomes of patients with and without autoimmune‐related CID undergoing TAVI for the treatment of severe aortic stenosis. Methods and Results From a prospective registry, consecutive patients with TAVI were included. Baseline clinic and imaging data (echocardiographic and computed tomography) were analyzed. Long‐term (up to 5 years) clinical and echocardiographic outcomes were studied. Of 1000 consecutive patients (mean age 81±6 years, 46% female), 107 (11%) had CID; the most frequent entities included polymyalgia rheumatica (31%) and rheumatoid arthritis (28%). Patients with CID were predominantly female (60% versus 44%, P=0.002) and more often had pulmonary disorders (21% versus 13%, P=0.046) and atrial fibrillation (32% versus 20%, P=0.003). The presence of CID was associated with a higher rate of postinterventional infection (5% versus 1%, P=0.007) and further emerged as a risk factor for rehospitalization for bleeding or infection (hazard ratio, 1.93 and 1.62, respectively). Premature valve degeneration, endocarditis, and all‐cause mortality were not increased among patients with CID. Conclusions This real‐world analysis found that patients with CID undergoing TAVI were associated with a higher risk of postinterventional infectious complications and rehospitalization due to infection. However, valve durability and survival seem not to differ between patients with TAVI with versus without CID.

Keywords

• chronic inflammatory disease
• long‐term outcome
• TAVI
• TAVR