NCDR Study Finds TMVR Improves Health in Patients After One Year
Most patients who are still alive one year after undergoing transcatheter mitral valve repair (TMVR) have improvements in symptoms, functional status and quality of life, according to a study published Nov. 21 in JAMA Cardiology.
Suzanne V. Arnold, MD, MHA, et al., measured changes in health status of TMVR patients by using the STS/ACC TVT Registry to analyze patients' Kansas City Cardiomyopathy Questionnaire-Overall Summary (KCCQ-OS) scores 30 days and one year after the procedure.
A total of 7,504 patients underwent TMVR at 240 sites during the study period. KCCQ-OS data were available for 4,226 patients at 30 days. Among these patients, the average KCCQ-OS score increased from 41.9 at baseline to 66.7 at 30 days. Average KCCQ-OS scores also increased for the 1,124 patients for whom one-year data were available – from 42.3 at baseline to 71.4 at one year. Lower KCCQ-OS scores, a history of atrial fibrillation or severe lung disease, presence of a permanent pacemaker, and home oxygen use were associated with poorer health status at 30 days. At one year, 54.2 percent of patients were alive and well, and 21.9 percent had consistently poor health, defined as a KCCQ-OS score of less than 60. The one-year mortality rate was 23 percent.
Although the long-term mortality rate is high, the study suggests that TMVR patients who are living one year after the procedure have strong health benefits that are consistent across patient populations. In addition, the study's findings that certain factors are associated with lower 30-day health status could help improve patient selection and expectations for recovery, the authors conclude.
"The STS/ACC TVT Registry is a national learning machine that provides all stakeholders with new insights into these therapies via multiple publications and presentations," commented John D. Carroll, MD, FACC, chair of the STS/ACC TVT Registry. "The value of the registry has been enormous for all stakeholders," he adds.
Keywords: Atrial Fibrillation, Patient Selection, Quality of Life, Mitral Valve, Registries, National Cardiovascular Data Registries, STS/ACC TVT Registry, Pacemaker, Artificial, Cardiomyopathies
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