biostudies-literatureUnknown2(7)Higuchi R<h4>Background</h4>Nonagenarians are a growing age group in patients undergoing transcatheter aortic valve replacement (TAVR); however, the appropriate use of TAVR in this population remains discussed because of their limited life expectancy and worse outcome reported.<h4>Objectives</h4>The authors aimed to evaluate clinical characteristics and the prognostic impact of nonagenarians.<h4>Methods</h4>We analyzed consecutive patients undergoing transfemoral TAVR and were registered in the nationwide registry for TAVR in Japan (Japanese Transcatheter Valvular Therapies registry) between 2013 and 2018. The rate of 30-day and 1-year mortality and composite adverse event, comprising all-cause death, all stroke, and life-threatening/major bleeding, were assessed.<h4>Results</h4>Of the 15,028 registered patients during the study period, 2,215 (14.7%) were nonagenarians. Although the nonagenarians were less likely to have comorbid conditions (eg, diabetes mellitus and malignancy) than patients aged <90 y, they had a higher Society of Thoracic Surgeons risk score (8.8% vs 5.6%), mainly owing to their advanced age. The procedural characteristics were identical between 2 groups. The rate of 30-day mortality and composite endpoint was similar, whereas 1-year mortality and composite adverse events were increased among nonagenarians (10.3% vs 6.8% and 13.5% vs 9.2%, respectively), and nonagenarians were independently associated with these endpoints (HR: 1.21; 95% CI: 1.03-1.42; <i>P</i> = 0.023; HR: 1.24; 95% CI: 1.07-1.42; <i>P</i> = 0.004).<h4>Conclusions</h4>Of the 15,028 TAVR procedures performed in Japan between 2013 and 2018, 14.7% were performed in nonagenarians. These patients were carefully selected by a multidisciplinary heart team and showed 21% and 24% increase of 1-year mortality and composite adverse outcome.JACC. Asia856-864https://www.ebi.ac.uk/biostudies/studies/S-EPMC9876954biostudies-literatureOutcome of Nonagenarians Undergoing Transfemoral Transcatheter Aortic Valve Replacement: A Nationwide Registry Analysis From Japan.PMC9876954Higuchi RSaji MKohsaka SKumamaru HTakayama MNanasato MShimizu HTakamisawa IShimokawa TfalseOutcome of Nonagenarians Undergoing Transfemoral Transcatheter Aortic Valve Replacement: A Nationwide Registry Analysis From Japan.<h4>Background</h4>Nonagenarians are a growing age group in patients undergoing transcatheter aortic valve replacement (TAVR); however, the appropriate use of TAVR in this population remains discussed because of their limited life expectancy and worse outcome reported.<h4>Objectives</h4>The authors aimed to evaluate clinical characteristics and the prognostic impact of nonagenarians.<h4>Methods</h4>We analyzed consecutive patients undergoing transfemoral TAVR and were registered in the nationwide registry for TAVR in Japan (Japanese Transcatheter Valvular Therapies registry) between 2013 and 2018. The rate of 30-day and 1-year mortality and composite adverse event, comprising all-cause death, all stroke, and life-threatening/major bleeding, were assessed.<h4>Results</h4>Of the 15,028 registered patients during the study period, 2,215 (14.7%) were nonagenarians. Although the nonagenarians were less likely to have comorbid conditions (eg, diabetes mellitus and malignancy) than patients aged <90 y, they had a higher Society of Thoracic Surgeons risk score (8.8% vs 5.6%), mainly owing to their advanced age. The procedural characteristics were identical between 2 groups. The rate of 30-day mortality and composite endpoint was similar, whereas 1-year mortality and composite adverse events were increased among nonagenarians (10.3% vs 6.8% and 13.5% vs 9.2%, respectively), and nonagenarians were independently associated with these endpoints (HR: 1.21; 95% CI: 1.03-1.42; <i>P</i> = 0.023; HR: 1.24; 95% CI: 1.07-1.42; <i>P</i> = 0.004).<h4>Conclusions</h4>Of the 15,028 TAVR procedures performed in Japan between 2013 and 2018, 14.7% were performed in nonagenarians. These patients were carefully selected by a multidisciplinary heart team and showed 21% and 24% increase of 1-year mortality and composite adverse outcome.2022-01-01T00:00:00Z2022 Dec2025-04-27T00:51:14.315Z2025-04-06T18:02:39.433ZS-EPMC98769543671375310.1016/j.jacasi.2022.08.007