Statin Therapy and Long Term Mortality Following Trans-catheter Aortic Valve Implantation

Background: Increased inflammatory response following aortic valve replacement is linked to higher post procedural mortality. The aim of the present analysis was to assess the impact of baseline statin therapy on procedural outcomes and mortality following trans-catheter aortic valve implantation (TAVI).

Methods: We performed a retrospective analysis on patients undergoing TAVI stratified to three statin therapy groups: high intensity statin (HIS), low-medium intensity statins (LMIS), and no statin (NS).

Results: Included were 1,238 patients. Patients treated with HIS were significantly younger, had higher BMI, lower STS score and higher prevalence of dyslipidemia, hypertension, past stroke and ischemic heart disease. Procedural outcomes were similar between groups. There were no statistically significant short-term mortality differences at 1-month (2.2% vs. 2.1% vs. 3.5%, p=0.50) and 1-year (6.9% vs. 9.3% vs. 14.2%, p=0.15), albeit the observed numerical trend. As for long-term mortality, (median follow time of 2.5 years, IQR 1.3-4.2) lower mortality rates were observed in the HIS group (14.5% vs. 25.2% vs. 36.6%, p=0.001). As compared to NS, the HIS group was significantly associated with reduced risk of long term mortality in multivariate analysis (HR=0.59, 95%CI 0.37-0.96, p=0.03).

Conclusion: Baseline HIS therapy is associated with reduced rates of long term morality following TAVI.