Longer wait times worsen post-TAVR survival in the long run

Patients who wait a longer time before receiving their transcatheter aortic valve replacement (TAVR) procedures face higher 1-year mortality rates post-operation, a recent study has found.

The study included 383 TAVR recipients, of whom 21 (5.5 percent) and 55 (14.4 percent) had died at 30 days and 1 year, respectively. Those who died more often had chronic kidney disease, had impaired heart function, and were deemed to be at significantly higher short-term risk of mortality after cardiac procedures.

The mean wait time to TAVR was 144.2 days, and patients who died waited for a significantly longer time than their surviving counterparts (mean, 168 vs 140.2 days; p=0.01).

Cox regression analysis confirmed that a longer wait time was a significant risk factor for 1-year mortality (hazard ratio [HR], 1.02, 95 percent confidence interval [CI], 1.002–1.04; p=0.02). Sensitivity analyses taking waiting time as a categorical variable or accounting for factors that differed between patients who died vs survived did not alter the findings.

Of note, wait time did not yield such a significant detrimental effect on in-hospital and 30-day mortality, nor on other adverse outcomes such as heart failure, arrhythmias, myocardial infection, strokes, or bleeding events.

“Our study shows that wait times remain important in daily practice and are associated with a 2-percent per week increase of 1-year mortality after referral. Our findings underscore the need for physicians and health system administrators to minimize such delays in order to improve prognosis,” the researchers said.