A propensity score matched analysis of long-term mortality outcomes in patients aged 50 to 70 years after isolated mechanical versus bioprosthetic aortic valve replacement in Newfoundland and Labrador

Buckley, Alvan (2020) A propensity score matched analysis of long-term mortality outcomes in patients aged 50 to 70 years after isolated mechanical versus bioprosthetic aortic valve replacement in Newfoundland and Labrador. Masters thesis, Memorial University of Newfoundland.

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Abstract

OBJECTIVE: Compare long-term mortality of patients after mechanical versus bioprosthetic aortic valve replacement in Newfoundland and Labrador METHODS: Retrospective cohort analysis of patients aged 50 to 70 years who underwent aortic valve replacement in Newfoundland and Labrador between 2006 and 2014. A logistic regression propensity score generated a subset of 52 matched patients. The long-term outcome of survival was assessed. RESULTS: Of 189 patients included, 135 (71%) received mechanical valves, while 54 (29%) received bioprosthetic valves. The mean age in the matched group was 63 (mechanical) and 64 years (bioprosthetic) (P = 0.64). Mean follow-up was 8.1 (maximum 13.8) years. Survival at 30 days, 1, 5, and 10 years was: 100%, 96%, 85%, and 81% (mechanical) versus 100%, 96%, 89%, and 67% (bioprosthetic). The hazard ratio for mortality between mechanical and bioprosthetic valves was 0.64 (95% CI 0.18-2.3, P = 0.491). Secondary outcomes revealed that the most common cause of death to be cardiovascular in etiology (39%), followed by malignancies (27%). CONCLUSIONS: We found no statistically significant difference in long-term survival in patients aged 50 to 70 years after mechanical versus bioprosthetic aortic valve replacement.

Item Type: Thesis (Masters)
URI: http://research.library.mun.ca/id/eprint/14744
Item ID: 14744
Additional Information: Includes bibliographical references (pages 67-74).
Keywords: Newfoundland and Labrador, Aortic valve replacement, Mortality, Mechanical aortic valve, Bioprosthetic aortic valve
Department(s): Medicine, Faculty of
Date: October 2020
Date Type: Submission
Medical Subject Heading: Heart Valve Prosthesis--statistics & numerical data; Bioprosthesis--statistics & numerical data; Newfoundland and Labrador.

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