Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study

Background Prior studies showed that life expectancy in patients who underwent surgical aortic valve replacement (AVR) was lower than in the general population. Explanations for this shorter life expectancy are unknown. The aim of this nationwide, observational cohort study was to investigate the ca...

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Autores principales:	Natalie Glaser, Michael Persson, Anders Franco‐Cereceda, Ulrik Sartipy
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	aortic valve replacement cardiac surgery cause of death life expectancy Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/b453d88dfbb54a0f9c13f093d0ffeb63
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spelling	oai:doaj.org-article:b453d88dfbb54a0f9c13f093d0ffeb632021-11-16T10:22:43ZCause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study10.1161/JAHA.121.0226272047-9980https://doaj.org/article/b453d88dfbb54a0f9c13f093d0ffeb632021-11-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.022627https://doaj.org/toc/2047-9980Background Prior studies showed that life expectancy in patients who underwent surgical aortic valve replacement (AVR) was lower than in the general population. Explanations for this shorter life expectancy are unknown. The aim of this nationwide, observational cohort study was to investigate the cause‐specific death following surgical AVR. Methods and Results We included 33 018 patients who underwent primary surgical AVR in Sweden between 1997 and 2018, with or without coronary artery bypass grafting. The SWEDEHEART (Swedish Web‐System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies) register and other national health‐data registers were used to obtain and characterize the study cohort and to identify causes of death, categorized as cardiovascular mortality, cancer mortality, or other causes of death. The relative risks for cause‐specific mortality in patients who underwent AVR compared with the general population are presented as standardized mortality ratios. During a mean follow‐up period of 7.3 years (maximum 22.0 years), 14 237 (43%) patients died. The cumulative incidence of death from cardiovascular, cancer‐related, or other causes was 23.5%, 8.3%, and 11.6%, respectively, at 10 years, and 42.8%, 12.8%, and 23.8%, respectively, at 20 years. Standardized mortality ratios for cardiovascular, cancer‐related, and other causes of death were 1.79 (95% CI, 1.75–1.83), 1.00 (95% CI, 0.97–1.04), and 1.08 (95% CI, 1.05–1.12), respectively. Conclusions We found that life expectancy following AVR was lower than in the general population. Lower survival after AVR was explained by an increased relative risk of cardiovascular death. Future studies should focus on the role of earlier surgery in patients with asymptomatic aortic stenosis and on optimizing treatment and follow‐up after AVR. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02276950.Natalie GlaserMichael PerssonAnders Franco‐CerecedaUlrik SartipyWileyarticleaortic valve replacementcardiac surgerycause of deathlife expectancyDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aortic valve replacement cardiac surgery cause of death life expectancy Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	aortic valve replacement cardiac surgery cause of death life expectancy Diseases of the circulatory (Cardiovascular) system RC666-701 Natalie Glaser Michael Persson Anders Franco‐Cereceda Ulrik Sartipy Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study
description	Background Prior studies showed that life expectancy in patients who underwent surgical aortic valve replacement (AVR) was lower than in the general population. Explanations for this shorter life expectancy are unknown. The aim of this nationwide, observational cohort study was to investigate the cause‐specific death following surgical AVR. Methods and Results We included 33 018 patients who underwent primary surgical AVR in Sweden between 1997 and 2018, with or without coronary artery bypass grafting. The SWEDEHEART (Swedish Web‐System for Enhancement and Development of Evidence‐Based Care in Heart Disease Evaluated According to Recommended Therapies) register and other national health‐data registers were used to obtain and characterize the study cohort and to identify causes of death, categorized as cardiovascular mortality, cancer mortality, or other causes of death. The relative risks for cause‐specific mortality in patients who underwent AVR compared with the general population are presented as standardized mortality ratios. During a mean follow‐up period of 7.3 years (maximum 22.0 years), 14 237 (43%) patients died. The cumulative incidence of death from cardiovascular, cancer‐related, or other causes was 23.5%, 8.3%, and 11.6%, respectively, at 10 years, and 42.8%, 12.8%, and 23.8%, respectively, at 20 years. Standardized mortality ratios for cardiovascular, cancer‐related, and other causes of death were 1.79 (95% CI, 1.75–1.83), 1.00 (95% CI, 0.97–1.04), and 1.08 (95% CI, 1.05–1.12), respectively. Conclusions We found that life expectancy following AVR was lower than in the general population. Lower survival after AVR was explained by an increased relative risk of cardiovascular death. Future studies should focus on the role of earlier surgery in patients with asymptomatic aortic stenosis and on optimizing treatment and follow‐up after AVR. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02276950.
format	article
author	Natalie Glaser Michael Persson Anders Franco‐Cereceda Ulrik Sartipy
author_facet	Natalie Glaser Michael Persson Anders Franco‐Cereceda Ulrik Sartipy
author_sort	Natalie Glaser
title	Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study
title_short	Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study
title_full	Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study
title_fullStr	Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study
title_full_unstemmed	Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study
title_sort	cause of death after surgical aortic valve replacement: swedeheart observational study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/b453d88dfbb54a0f9c13f093d0ffeb63
work_keys_str_mv	AT natalieglaser causeofdeathaftersurgicalaorticvalvereplacementswedeheartobservationalstudy AT michaelpersson causeofdeathaftersurgicalaorticvalvereplacementswedeheartobservationalstudy AT andersfrancocereceda causeofdeathaftersurgicalaorticvalvereplacementswedeheartobservationalstudy AT ulriksartipy causeofdeathaftersurgicalaorticvalvereplacementswedeheartobservationalstudy
_version_	1718426569844719616

Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study

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