Baseline Characteristics of isolated AVR
| Surgical bioprostheses | Mechanical prostheses | TAVI | ||||||||||
| 2008–2011 | 2012–2015 | 2016–2020 | P-value* | 2008–2011 | 2012–2015 | 2016–2020 | P value* | 2008–2011 | 2012–2015 | 2016–2020 | P-value* | |
| Demographics | ||||||||||||
| Number of AVR | 1664 | 1888 | 1649 | 0.024 | 538 | 399 | 410 | <0.001 | 608 | 1396 | 3761 | <0.001 |
| Age in years, median (25th–75th percentile) | 74 (68.6–79.2) | 73.1 (68.0–78.3) | 72.2 (67.4–75.9) | <0.001 | 58.7 (51.8–63.5) | 56.6 (50.8–61.1) | 56.3 (51.1–60.0) | <0.001 | 81.7 (77.0–85.3) | 82.0 (77.1–85.8) | 81.4 (76.8–85.0) | 0.009 |
| Age groups, n (%) | <0.001 | 0.806 | 0.383 | |||||||||
| <75 | 926 (55.6) | 1135 (60.1) | 1133 (68.7) | 524 (97.4) | 392 (98.2) | 399 (97.3) | 109 (17.9) | 244 (17.5) | 703 (18.7) | |||
| >=75 | 738 (44.4) | 753 (39.9) | 516 (31.3) | 14 (2.6) | 7 (1.8) | 11 (2.7) | 499 (82.1) | 1152 (82.5) | 3058 (81.3) | |||
| Sex (Male), n (%) | 922 (55.4) | 1156 (61.2) | 1093 (66.3) | <0.001 | 374 (69.5) | 283 (70.9) | 294 (71.7) | 0.133 | 294 (48.4) | 734 (52.6) | 2140 (56.9) | <0.001 |
| TAVI access, n (%) | <0.001 | |||||||||||
| Transfemoral | – | – | – | – | – | – | – | – | 385 (63.3) | 1097 (78.6) | 3411 (90.7) | |
| Other | – | – | – | – | – | – | – | – | 223 (36.7) | 299 (21.4) | 350 (9.3) | |
| In-hospital | ||||||||||||
| Length of stay (days), median (25th–75th percentile) | 9 [7.0–14.2) | 8 (6–12) | 6(5–9) | <0.001 | 7(6–10) | 7(6–9) | 6(5–8) | <0.001 | 8(6–13) | 6(4–8) | 3(2–5) | <0.001 |
| Implantation of PPM†, n (%) | 60 (3.6) | 52 (2.8) | 74 (4.5) | 0.243 | 17 (3.2) | 7 (1.8) | 15 (3.7) | 0.586 | 85 (14.0) | 191 (13.7) | 488 (13.0) | 0.715 |
| History of cardiovascular disease, n (%) | ||||||||||||
| Atrial fibrillation | 376 (22.6) | 454 (24.0) | 330 (20.0) | 0.033 | 65 (12.1) | 52 (13.0) | 33 (8.0) | 0.031 | 209 (34.4) | 570 (40.8) | 1279 (34.0) | 0.002 |
| CIED | 56 (3.4) | 76 (4.0) | 51 (3.1) | 0.585 | 10 (1.9) | 13 (3.3) | 13 (3.2) | 0.265 | 50 (8.2) | 152 (10.9) | 353 (9.4) | 0.601 |
| Heart failure | 337 (20.3) | 361 (19.1) | 241 (14.6) | <0.001 | 62 (11.5) | 51 (12.8) | 38 (9.3) | 0.256 | 239 (39.3) | 496 (35.5) | 1025 (27.3) | <0.001 |
| IHD | 675 (40.6) | 681 (36.1) | 417 (25.3) | <0.001 | 145 (27.0) | 91 (22.8) | 63 (15.4) | <0.001 | 413 (67.9) | 813 (58.2) | 1741 (46.3) | <0.001 |
| Comorbidity, medical history of n (%) | ||||||||||||
| Diabetes | 283 (17.0) | 393 (20.8) | 294 (17.8) | 0.434 | 77 (14.3) | 60 (15.0) | 52 (12.7) | 0.332 | 115 (18.9) | 334 (23.9) | 895 (23.8) | 0.083 |
| Cancer | 216 (13.0) | 287 (15.2) | 247 (15.0) | 0.029 | 35 (6.5) | 23 (5.8) | 24 (5.9) | 0.904 | 93 (15.3) | 273 (19.6) | 857 (22.8) | <0.001 |
| CKD | 56 (3.4) | 81 (4.3) | 37 (2.2) | 0.025 | 22 (4.1) | 20 (5.0) | 14 (3.4) | 0.901 | 46 (7.6) | 105 (7.5) | 198(5.3) | 0.002 |
| COPD | 212 (12.7) | 226 (12.0) | 149 (9.0) | <0.001 | 36 (6.7) | 23 (5.8) | 26 (6.3) | 0.673 | 114 (18.8) | 270 (19.3) | 536 (14.3) | <0.001 |
| Dialysis | 18 (1.1) | 23 (1.2) | 7 (0.4) | 0.034 | 6 (1.1) | 7 (1.8) | 7 (1.7) | 0.254 | 19 (3.1) | 46 (3.3) | 63 (1.7) | <0.001 |
| Hypertension | 980 (58.9) | 1042 (55.2) | 809 (49.1) | <0.001 | 219 (40.7) | 150 (37.6) | 125 (30.5) | <0.001 | 464 (76.3) | 1054 (75.5) | 2610 (69.4) | <0.001 |
| PAD | 85 (5.1) | 118 (6.2) | 46 (2.8) | 0.002 | 14 (2.6) | 11 (2.8) | 6 (1.5) | 0.165 | 76 (12.5) | 146 (10.5) | 241 (6.4) | <0.001 |
| Prior stroke/TIA | 151 (9.1) | 197 (10.4) | 134 (8.1) | 0.635 | 32 (5.9) | 17 (4.3) | 12 (2.9) | 0.050 | 94 (15.5) | 209 (15.0) | 503 (13.4) | 0.061 |
| Charlson Comorbidity Index, n (%) | <0.001 | 0.460 | <0.001 | |||||||||
| 0 | 856 (51.4) | 962 (51) | 959 (58.2) | 359 (66.7) | 264 (66.2) | 289 (70.5) | 182 (29.9) | 413 (29.6) | 1423 (37.8) | |||
| 1–2 | 645 (38.8) | 713 (37.7) | 570 (34.5) | 148 (27.5) | 118 (29.6) | 104 (25.4) | 282 (46.4) | 632 (45.3) | 1612 (42.9) | |||
| ≥3 | 163 (9.8) | 213 (11.3) | 120 (7.3) | 31 (5.8) | 17 (4.2) | 17 (4.1) | 144 (23.7) | 351 (25.1) | 726 (19.3) | |||
| Prehospital medication (<6 months), n (%) | ||||||||||||
| Anticoagulant treatment | 213 (12.8) | 303 (16.0) | 252 (15.3) | 0.018 | 42 (7.8) | 39 (9.8) | 25 (6.1) | 0.151 | 139 (22.9) | 467 (33.5) | 1288 (34.2) | <0.001 |
| Beta-blocker | 681 (40.9) | 721 (38.2) | 499 (30.3) | <0.001 | 171 (31.8) | 107 (26.8) | 85 (20.7) | <0.001 | 334 (54.9) | 780 (55.9) | 1748 (46.5) | <0.001 |
| Lipid-lowering medication | 938 (56.4) | 1067 (56.5) | 947 (57.4) | 0.476 | 245 (45.5) | 152 (38.1) | 145 (35.4) | <0.001 | 397 (65.3) | 898 (64.3) | 2354 (62.6) | 0.707 |
| RAS inhibition | 731 (43.9) | 882 (46.7) | 801 (48.6) | 0.014 | 197 (36.6) | 151 (37.8) | 133 (32.4) | 0.120 | 290 (47.7) | 737 (52.8) | 2041 (54.3) | 0.002 |
Bold values corresponds to a p-value < 0.05
*All p values were test of trend by each calendar year.
†First-time permanent pacemaker within 30 days of AVR procedure.
CIED, cardiac implantable electronic devices; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; IHD, ischaemic heart disease; PAD, peripheral artery disease; PPM, permanent pacemaker; TIA, transient ischaemic attack.