Transcatheter aortic valve implantation vs. surgical aortic valve replacement for aortic stenosis in Taiwan: A population-based cohort study
Aortic stenosis (AS) is a heart valve disease characterized by left ventricular outflow fixed obstruction. It can be managed by surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). However, real-world evidence for TAVI or SAVR outcomes is lacking in Taiwan. Thi...
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| description | Aortic stenosis (AS) is a heart valve disease characterized by left ventricular outflow fixed obstruction. It can be managed by surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). However, real-world evidence for TAVI or SAVR outcomes is lacking in Taiwan. This study aimed to compare the clinical outcomes of TAVI and SAVR for treating of AS in Taiwan.
The National Health Insurance Research Database is a nationally representative cohort that contains detailed registry and claims data from all 23 million residents of Taiwan. This retrospective cohort study used this database to compare patients who underwent SAVR (bioprosthetic valves) or TAVI from 2017 to 2019. Survival outcomes and length of hospital stay (LOS) and intensive care unit (ICU) stay between TAVI and SAVR in the matched cohort. A Cox proportional hazards model was performed to identify the effect of treatment type on survival rates while controlling variables including age, gender, and comorbidities.
We identified 475 and 1605 patients who underwent TAVI and SAVR with a bioprosthetic valve, respectively. Patients who underwent TAVI were older (82.19 vs. 68.75 y/o) and more likely to be female (55.79% vs. 42.31%) compared with patients who underwent SAVR. Propensity score matching (PSM) on age, gender, and Elixhauser Comorbidity Index (ECI) score revealed that 375 patients who underwent TAVI were matched with patients who underwent SAVR. A significant difference was found in survival rates between TAVI and SAVR. The 1-year mortality rate was 11.44% with TAVI and 17.55% with SAVR. Both the mean total LOS (19.86 vs. 28.24 days) and mean ICU stay (6.47 vs. 11.12 days) for patients who underwent TAVI were shorter than those who underwent SAVR.
Patients who had undergone TAVI had better survival outcomes and shorter LOS compared with patients who had undergone SAVR in Taiwan. |
| doi_str_mv | 10.1371/journal.pone.0285191 |
| format | Article |
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The National Health Insurance Research Database is a nationally representative cohort that contains detailed registry and claims data from all 23 million residents of Taiwan. This retrospective cohort study used this database to compare patients who underwent SAVR (bioprosthetic valves) or TAVI from 2017 to 2019. Survival outcomes and length of hospital stay (LOS) and intensive care unit (ICU) stay between TAVI and SAVR in the matched cohort. A Cox proportional hazards model was performed to identify the effect of treatment type on survival rates while controlling variables including age, gender, and comorbidities.
We identified 475 and 1605 patients who underwent TAVI and SAVR with a bioprosthetic valve, respectively. Patients who underwent TAVI were older (82.19 vs. 68.75 y/o) and more likely to be female (55.79% vs. 42.31%) compared with patients who underwent SAVR. Propensity score matching (PSM) on age, gender, and Elixhauser Comorbidity Index (ECI) score revealed that 375 patients who underwent TAVI were matched with patients who underwent SAVR. A significant difference was found in survival rates between TAVI and SAVR. The 1-year mortality rate was 11.44% with TAVI and 17.55% with SAVR. Both the mean total LOS (19.86 vs. 28.24 days) and mean ICU stay (6.47 vs. 11.12 days) for patients who underwent TAVI were shorter than those who underwent SAVR.
Patients who had undergone TAVI had better survival outcomes and shorter LOS compared with patients who had undergone SAVR in Taiwan.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0285191</identifier><identifier>PMID: 37134111</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Analysis ; Anemia ; Aorta ; Aortic stenosis ; Aortic valve ; Aortic Valve - surgery ; Aortic Valve Stenosis ; Biology and Life Sciences ; Cardiac arrhythmia ; Care and treatment ; Cohort analysis ; Cohort Studies ; Comorbidity ; Complications and side effects ; Data science ; Diabetes ; Electrolytes ; Female ; Gender ; Hazard identification ; Heart ; Heart diseases ; Heart failure ; Heart Valve Prosthesis Implantation - adverse effects ; Heart valve replacement ; Heart valves ; Hospitals ; Humans ; Hypertension ; Hypothyroidism ; Implantation ; Liver diseases ; Male ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Mortality ; National health insurance ; Online databases ; Patient outcomes ; Patients ; People and Places ; Population studies ; Population-based studies ; Retrospective Studies ; Rheumatic heart disease ; Rheumatoid arthritis ; Risk Factors ; Statistical models ; Survival ; Taiwan - epidemiology ; Transcatheter Aortic Valve Replacement - adverse effects ; Treatment Outcome ; Variables ; Ventricle</subject><ispartof>PloS one, 2023-05, Vol.18 (5), p.e0285191-e0285191</ispartof><rights>Copyright: © 2023 Chung 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.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Chung et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Chung et al 2023 Chung et al</rights><rights>2023 Chung et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c693t-1281601098dd8a76b1786792207720c21901713d33af750cee27a16f69ef7e133</citedby><cites>FETCH-LOGICAL-c693t-1281601098dd8a76b1786792207720c21901713d33af750cee27a16f69ef7e133</cites><orcidid>0000-0002-3096-8974</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155988/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155988/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37134111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Huang, Kuo-Cherh</contributor><creatorcontrib>Chung, Ching-Hu</creatorcontrib><creatorcontrib>Wang, Yu-Jen</creatorcontrib><creatorcontrib>Jiao, Xiayu</creatorcontrib><creatorcontrib>Lee, Chia-Ying</creatorcontrib><title>Transcatheter aortic valve implantation vs. surgical aortic valve replacement for aortic stenosis in Taiwan: A population-based cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Aortic stenosis (AS) is a heart valve disease characterized by left ventricular outflow fixed obstruction. It can be managed by surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). However, real-world evidence for TAVI or SAVR outcomes is lacking in Taiwan. This study aimed to compare the clinical outcomes of TAVI and SAVR for treating of AS in Taiwan.
The National Health Insurance Research Database is a nationally representative cohort that contains detailed registry and claims data from all 23 million residents of Taiwan. This retrospective cohort study used this database to compare patients who underwent SAVR (bioprosthetic valves) or TAVI from 2017 to 2019. Survival outcomes and length of hospital stay (LOS) and intensive care unit (ICU) stay between TAVI and SAVR in the matched cohort. A Cox proportional hazards model was performed to identify the effect of treatment type on survival rates while controlling variables including age, gender, and comorbidities.
We identified 475 and 1605 patients who underwent TAVI and SAVR with a bioprosthetic valve, respectively. Patients who underwent TAVI were older (82.19 vs. 68.75 y/o) and more likely to be female (55.79% vs. 42.31%) compared with patients who underwent SAVR. Propensity score matching (PSM) on age, gender, and Elixhauser Comorbidity Index (ECI) score revealed that 375 patients who underwent TAVI were matched with patients who underwent SAVR. A significant difference was found in survival rates between TAVI and SAVR. The 1-year mortality rate was 11.44% with TAVI and 17.55% with SAVR. Both the mean total LOS (19.86 vs. 28.24 days) and mean ICU stay (6.47 vs. 11.12 days) for patients who underwent TAVI were shorter than those who underwent SAVR.
Patients who had undergone TAVI had better survival outcomes and shorter LOS compared with patients who had undergone SAVR in Taiwan.</description><subject>Age</subject><subject>Analysis</subject><subject>Anemia</subject><subject>Aorta</subject><subject>Aortic stenosis</subject><subject>Aortic valve</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis</subject><subject>Biology and Life Sciences</subject><subject>Cardiac arrhythmia</subject><subject>Care and treatment</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Data science</subject><subject>Diabetes</subject><subject>Electrolytes</subject><subject>Female</subject><subject>Gender</subject><subject>Hazard identification</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Heart valve replacement</subject><subject>Heart valves</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypothyroidism</subject><subject>Implantation</subject><subject>Liver diseases</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>National health insurance</subject><subject>Online databases</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>People and Places</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Retrospective Studies</subject><subject>Rheumatic heart disease</subject><subject>Rheumatoid arthritis</subject><subject>Risk Factors</subject><subject>Statistical models</subject><subject>Survival</subject><subject>Taiwan - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chung, Ching-Hu</au><au>Wang, Yu-Jen</au><au>Jiao, Xiayu</au><au>Lee, Chia-Ying</au><au>Huang, Kuo-Cherh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcatheter aortic valve implantation vs. surgical aortic valve replacement for aortic stenosis in Taiwan: A population-based cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-05-03</date><risdate>2023</risdate><volume>18</volume><issue>5</issue><spage>e0285191</spage><epage>e0285191</epage><pages>e0285191-e0285191</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Aortic stenosis (AS) is a heart valve disease characterized by left ventricular outflow fixed obstruction. It can be managed by surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). However, real-world evidence for TAVI or SAVR outcomes is lacking in Taiwan. This study aimed to compare the clinical outcomes of TAVI and SAVR for treating of AS in Taiwan.
The National Health Insurance Research Database is a nationally representative cohort that contains detailed registry and claims data from all 23 million residents of Taiwan. This retrospective cohort study used this database to compare patients who underwent SAVR (bioprosthetic valves) or TAVI from 2017 to 2019. Survival outcomes and length of hospital stay (LOS) and intensive care unit (ICU) stay between TAVI and SAVR in the matched cohort. A Cox proportional hazards model was performed to identify the effect of treatment type on survival rates while controlling variables including age, gender, and comorbidities.
We identified 475 and 1605 patients who underwent TAVI and SAVR with a bioprosthetic valve, respectively. Patients who underwent TAVI were older (82.19 vs. 68.75 y/o) and more likely to be female (55.79% vs. 42.31%) compared with patients who underwent SAVR. Propensity score matching (PSM) on age, gender, and Elixhauser Comorbidity Index (ECI) score revealed that 375 patients who underwent TAVI were matched with patients who underwent SAVR. A significant difference was found in survival rates between TAVI and SAVR. The 1-year mortality rate was 11.44% with TAVI and 17.55% with SAVR. Both the mean total LOS (19.86 vs. 28.24 days) and mean ICU stay (6.47 vs. 11.12 days) for patients who underwent TAVI were shorter than those who underwent SAVR.
Patients who had undergone TAVI had better survival outcomes and shorter LOS compared with patients who had undergone SAVR in Taiwan.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37134111</pmid><doi>10.1371/journal.pone.0285191</doi><tpages>e0285191</tpages><orcidid>https://orcid.org/0000-0002-3096-8974</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2808953192 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Analysis Anemia Aorta Aortic stenosis Aortic valve Aortic Valve - surgery Aortic Valve Stenosis Biology and Life Sciences Cardiac arrhythmia Care and treatment Cohort analysis Cohort Studies Comorbidity Complications and side effects Data science Diabetes Electrolytes Female Gender Hazard identification Heart Heart diseases Heart failure Heart Valve Prosthesis Implantation - adverse effects Heart valve replacement Heart valves Hospitals Humans Hypertension Hypothyroidism Implantation Liver diseases Male Medical research Medicine and Health Sciences Medicine, Experimental Mortality National health insurance Online databases Patient outcomes Patients People and Places Population studies Population-based studies Retrospective Studies Rheumatic heart disease Rheumatoid arthritis Risk Factors Statistical models Survival Taiwan - epidemiology Transcatheter Aortic Valve Replacement - adverse effects Treatment Outcome Variables Ventricle |
| title | Transcatheter aortic valve implantation vs. surgical aortic valve replacement for aortic stenosis in Taiwan: A population-based cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T13%3A49%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Transcatheter%20aortic%20valve%20implantation%20vs.%20surgical%20aortic%20valve%20replacement%20for%20aortic%20stenosis%20in%20Taiwan:%20A%20population-based%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Chung,%20Ching-Hu&rft.date=2023-05-03&rft.volume=18&rft.issue=5&rft.spage=e0285191&rft.epage=e0285191&rft.pages=e0285191-e0285191&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0285191&rft_dat=%3Cgale_plos_%3EA747925151%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2808953192&rft_id=info:pmid/37134111&rft_galeid=A747925151&rft_doaj_id=oai_doaj_org_article_20f1eca50f47448e9b24387f42ed71f1&rfr_iscdi=true |