Résumé
Aims Despite procedural success, certain patients fail to derive clinical benefit from transcatheter aortic valve implantation (TAVI). In a nationwide TAVI registry, we assessed the proportion of patients experiencing either a deterioration in quality of life (QoL) or death 1 year after TAVI, and the factors associated with these outcomes. Methods and results This prospective substudy of the FRANCE TAVI registry included patients enrolled between 2018 and 2019 who completed the EuroQoL-5-dimension-5-level (EQ-5D-5L) questionnaire at baseline and 1 year. Among the 3159 patients (median age 83 years), EQ-5D-5L visual analogue scale increased significantly from 60 (IQR 50-70) at baseline to 70 (IQR 50-80) at follow-up (P < 0.001). However, 459 patients (14.5%) experienced a deterioration in QoL, and 596 (18.9%) died within 1 year. According to a multivariable logistic model, factors significantly associated with poor outcome were frailty [OR 1.40, 95% confidence interval (CI) (1.08-1.83)], diabetes [OR 1.41, 95% CI (1.06-1.88)], chronic pulmonary disease [OR 1.55, 95% CI (1.09-2.20)], critical pre-operative status [OR 0.42, 95% CI (0.21-0.83)], left ventricular ejection fraction [OR 1.01, 95% CI (1.00-1.02)], mean aortic gradient at discharge [OR 0.97, 95% CI (0.95-1.00)], need for pacemaker implantation [OR 1.51, 95% CI (1.10-2.06)], anticoagulation therapy at discharge [OR 1.65, 95% CI (1.23-2.22)], and time to discharge [OR 1.04, 95% CI (1.01-1.07)]. Conclusion Although TAVI improved overall QoL, 14.5% of patients experienced a deterioration in QoL and 18.9% died within 1 year. Predictors included baseline comorbidities and post-procedural factors (anticoagulation at discharge and time to discharge), which are largely unpredictable.