Surgical aortic valve replacement may shorten life expectancy
Patients who had undergone aortic valve replacement (AVR) have shorter life expectancy than the general population, a study has found. Apart from being substantial, this loss in life expectancy increases with younger age.
During a mean follow-up of 6.8 years, the loss in life expectancy stood at 1.9 years (95 percent CI, 1.2–2.6 years) in patients who underwent primary surgical AVR. The 19-year observed survival rate was 21 percent, while the expected and relative survival rates were 34 percent and 63 percent (59–67 percent), respectively.
Younger age increased the estimated loss in life expectancy: 0.4 (0.3–0.5 years) vs 4.4 years (1.5–7.2 years) in patients ≥80 and <50 years of age, respectively. No difference was seen in loss in life expectancy between men and women.
“These results provide important information to quantify disease burden after AVR and are relevant for clinicians counseling patients before and after AVR,” the investigators said.
In total, 23,528 patients who underwent AVR with or without concomitant coronary artery bypass grafting in Sweden between 1995 and 2013 from the SWEDEHEART (Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies) register were included in the study.
Individual-level linking with other national health-data registers was conducted to gather baseline characteristics and vital status. The Human Mortality Database was accessed to obtain the expected survival from the general Swedish population matched by age, sex and year of surgery. The investigators used the relative survival as an estimate of cause-specific mortality and flexible parametric models based on relative survival to estimate the loss in life expectancy.