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Peer-reviewedCC BY 4.0JACC: Advances

Patterns of Postdischarge Heart Failure, Ischemic, and Bleeding Events After Transcatheter Aortic Valve Replacement

  • Shogo Okita1
  • Hideki Kitahara1
  • Hiroki Kuji2
  • Ko Miyakoda1
  • Ryo Toishi3
  • Tomoyoshi Kanda3
  • Yuichi Saito1
  • Kousei Tanaga2
  • Yoshitake Nakamura2
  • Kaoru Matsuura3
  • Yoshio Kobayashi1
  1. 1Department of Cardiovascular Medicine, Chiba University Hospital, Chiba, Japan
  2. 2Department of Cardiology, Chiba Cerebral and Cardiovascular Center, Chiba, Japan
  3. 3Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan
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Abstract

Background: Although outcomes after transcatheter aortic valve replacement (TAVR) have improved, heart failure (HF) hospitalization, ischemic events, and major bleeding remain clinical challenges in patients with severe aortic stenosis.

Objectives: The objective of the study was to evaluate the incidence, timing, and prognostic impact of these events after TAVR.

Methods: This two-center retrospective registry included 988 patients with severe aortic stenosis who underwent TAVR. Patients were grouped according to the first clinical event after discharge: HF hospitalization, ischemic events (myocardial infarction or ischemic stroke), major bleeding, or the event-free group. The timing of the first postdischarge event and all-cause mortality after the first event were evaluated.

Results: During a median follow-up of 665 days after discharge, 165 patients (16.7%) experienced any of these events. As first events, HF hospitalization, ischemic events, and major bleeding occurred in 80 (8.1%), 32 (3.2%), and 53 (5.4%) patients, respectively, whereas 823 (83.3%) were in the event-free group. Among patients with a first postdischarge event, major bleeding occurred earliest among the 3 event groups. One-year all-cause mortality after the first event was high across groups (HF hospitalization, 31.5%; ischemic events, 30.4%; major bleeding, 25.4%).

Conclusions: Among patients who experienced a first postdischarge event after TAVR, major bleeding occurred earlier than HF hospitalization or ischemic events. Once a first postdischarge event occurred, subsequent all-cause mortality was high across the 3 event groups. These findings suggest that event timing should be considered and careful clinical reassessment may be warranted when a first postdischarge event occurs after TAVR.

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Cite

BibTeXRIS
BibTeX
@article{okita2026patterns,
  title = {{Patterns of Postdischarge Heart Failure, Ischemic, and Bleeding Events After Transcatheter Aortic Valve Replacement}},
  author = {Shogo Okita and Hideki Kitahara and Hiroki Kuji and Ko Miyakoda and Ryo Toishi and Tomoyoshi Kanda and Yuichi Saito and Kousei Tanaga and Yoshitake Nakamura and Kaoru Matsuura and Yoshio Kobayashi},
  journal = {JACC: Advances},
  year = {2026},
  month = oct,
  doi = {10.1016/j.jacadv.2026.103387},
  url = {https://doi.org/10.1016/j.jacadv.2026.103387},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Patterns of Postdischarge Heart Failure, Ischemic, and Bleeding Events After Transcatheter Aortic Valve Replacement
AU  - Shogo Okita
AU  - Hideki Kitahara
AU  - Hiroki Kuji
AU  - Ko Miyakoda
AU  - Ryo Toishi
AU  - Tomoyoshi Kanda
AU  - Yuichi Saito
AU  - Kousei Tanaga
AU  - Yoshitake Nakamura
AU  - Kaoru Matsuura
AU  - Yoshio Kobayashi
PY  - 2026
DA  - 2026/10/26
JO  - JACC: Advances
DO  - 10.1016/j.jacadv.2026.103387
UR  - https://doi.org/10.1016/j.jacadv.2026.103387
AB  - Background: Although outcomes after transcatheter aortic valve replacement (TAVR) have improved, heart failure (HF) hospitalization, ischemic events, and major bleeding remain clinical challenges in patients with severe aortic stenosis.  Objectives: The objective of the study was to evaluate the incidence, timing, and prognostic impact of these events after TAVR.  Methods: This two-center retrospective registry included 988 patients with severe aortic stenosis who underwent TAVR. Patients were grouped according to the first clinical event after discharge: HF hospitalization, ischemic events (myocardial infarction or ischemic stroke), major bleeding, or the event-free group. The timing of the first postdischarge event and all-cause mortality after the first event were evaluated.  Results: During a median follow-up of 665 days after discharge, 165 patients (16.7%) experienced any of these events. As first events, HF hospitalization, ischemic events, and major bleeding occurred in 80 (8.1%), 32 (3.2%), and 53 (5.4%) patients, respectively, whereas 823 (83.3%) were in the event-free group. Among patients with a first postdischarge event, major bleeding occurred earliest among the 3 event groups. One-year all-cause mortality after the first event was high across groups (HF hospitalization, 31.5%; ischemic events, 30.4%; major bleeding, 25.4%).  Conclusions: Among patients who experienced a first postdischarge event after TAVR, major bleeding occurred earlier than HF hospitalization or ischemic events. Once a first postdischarge event occurred, subsequent all-cause mortality was high across the 3 event groups. These findings suggest that event timing should be considered and careful clinical reassessment may be warranted when a first postdischarge event occurs after TAVR.
SN  - 2772-963X
ER  -