Cost-effectiveness of transcatheter aortic valve implantation in patients with severe symptomatic aortic stenosis of intermediate surgical risk in Singapore

Table 1 Summary of clinical outcomes used in the base case analysis (based on PARTNER 2A trial) [10]

Clinical outcomes	TAVI (%)				SAVR (%)
Clinical outcomes	30 days	1 year	2 year	5 year	30 days	1 year	2 year	5 year
All-cause mortality	3	10	14.2	42.7	4.1	12.3	17.2	40.5
Disabling or major stroke	2.3	4.3	5.3	8.7	4.2	6	6.7	8.3
Rehospitalisation	5.5	13.1	18.4	32	6.5	14.8	17.1	24.1
MI	0.6	1.9	3	9.4	1.8	3.2	4.2	8.1
Major vascular complication	8.5	8.8	9	9.6	3.9	4.3	4.5	5.1
Life-threatening or disabling bleeding	6.7	11.1	13.6	21.1	41.4	43.4	44.7	48.6
Endocarditis	0	0.8	1.5	3.7	0	0.9	0.9	1.9
AKI	0.5	2.2	2.5	3.4	3	5.2	6.4	10
New PPI	8.1	9.6	11.4	15.1	7.1	9.5	10.8	13.5
TIA	0.9	2.6	3.8	5.8	0.3	1.8	2.3	4.3
Atrial fibrillation	4.9	5.9	7.4	11.7	26.7	27.6	27.8	30.7
Paravalvular aortic regurgitation	3.75	3.75	8.27	6.44	0.49	0.49	0.57	0.34

Abbreviations: AKI acute kidney injury, MI myocardial infarction, PPI permanent pacemaker implantation, SAVR surgical aortic valve replacement, TAVI transcatheter aortic valve implantation, TIA transient ischaemic attack
Notes: 1. All-cause mortality and disabling or major stroke were extracted from Kaplan–Meier curves presented in Leon et al. (2016) for intermediate-risk surgical patients [10]
2. Clinical outcomes data were available for only two years in transfemoral population for all variables except all-cause mortality, disabling or major stroke, repeat hospitalisation, TIA and paravalvular aortic regurgitation; beyond two years, the increased rates in incidence were assumed to be based on the last observed data for acute kidney injury, major bleeding and major vascular complication, or the same as that reported in pooled population (transfemoral and non-transfemoral) between 2^nd and 5^th year for atrial fibrillation, endocarditis, myocardial infarction and pacemaker implantation
3. Let RR_S be the relative risk for death due to having a stroke, M_NS and M be the mortality rate for those without stroke and the entire cohort respectively, whilst X is the proportion of the cohort with stroke. The adjusted mortality values are: M = X*RR_S*M_NS + (1 - X)*M_NS. This may be re-arranged to give M_NS = M/[X*RR_S + (1 - X)], as the mortality for those without stroke is the unknown

ISSN: 1472-6963