Outcomes of a Newly Established TAVI Program

Abstract

Background: We have previously reported 1 and 12 month outcomes for patients undergoing PCI involving DES and BMS. This analysis is now extended to investigate factors impacting on patient survival to eight years post PCI. Methods: Data for patients undergoing PCI at our institution has been maintained since 2003. Records (4028 procedures to March 2011) include baseline clinical and procedural data, along with one and twelve month Major Adverse Cardiac Events (MACE), defined as death, myocardial infarction (MI), target lesion revascularisation (TLR). In March 2011, the PCI register was updated with death data from the Queensland Registry of Births, Deaths and Marriages. Cox regression was used to determine significant factors impacting on survival post-PCI while propensity score matching was used to compare outcomes at 1 and 12 months for BMS and DES (>1 DES lesion classed DES). Results/discussion: Factors (plus hazard ratio) linked to survival include stent type (BMS: 1, DES: 0.57), age (<50: 1, 50-59: 1.4, 60-69: 3.4, 70-79: 8.1, 80+: 22), unstable angina (1.5), family history (0.74), diabetes (1.7), acute/rescue (3.4), multiple lesions (1.4), LVEF < 45% (2.8). Survival at seven years is greater for DES (91.5% vs. BMS: 85.5%, log rank p < 0.001). Propensity matched odds ratios at 1 and 12 months for TLR (0.12, p = 0.04: 0.42, p = 0.05) and MACE (0.22, p = 0.02: 0.37, p < 0.001) were derived.Conclusion: Use of DES at this institution has been linked to reduced MACE and TLR rates at 1 and 12 months. Survival beyond seven years favours DES. http://dx.