Slow gait speed predicts mortality after TAVI

Slow gait speed and an inability to walk may predict mortality risk after transcatheter aortic valve implantation (TAVI), a recent meta-analysis has found.

Researchers retrieved 12 eligible studies from the databases of PubMed and Web of Science. Seven studies were based on distance-limited walk test, while others measured gait speed according to time-based walk tests. Sample sizes ranged from 89 to 21,661 while follow-up lengths ranged from 30 days to 4 years.

Pooled analysis of all risk estimates showed that slow walkers were at a significantly greater risk of mortality (primary meta-analysis; odds/hazard ratio [OR/HR], 2.38, 95 percent confidence interval [CI], 1.63–3.47; p<0.00001). Being unable to walk had a similar effect (OR/HR, 1.75, 95 percent CI, 1.12–2.72; p=0.01).

Stratification according to the gait test used did reveal important differences. Slow gait, as measured by the 4- or 5-minute or 15-feet walk tests remained strongly and significantly correlated with mortality risk (HR, 2.83, 95 percent CI, 1.50–5.35; p<0.0001). A similar effect was seen when gait was measured using the 6-minute walk test (HR, 2.11, 95 percent CI, 1.37–3.24; p=0.0007). The difference in effect estimates between the two sub-analyses was not significant (p=0.45).

Similarly, sensitivity analysis confined to only those with 1-year follow-up (p<0.0001) and exclusion of those with unadjusted estimates (p=0.0002) did not significantly alter the effect of slow gait on mortality risk.