{"id":"6d8b3789e522","type":"article","url":"https://hartvaat.nl/2026/10/01/voorgebruik-van-opioiden-verhoogt-sterfte-en-ziekenhuisopnames-na-tavi-deens-coh/","title":"Voorgebruik van opioïden verhoogt sterfte en ziekenhuisopnames na TAVI — Deens cohort","title_en":"Associated prognostic impact of opioid use before Transcatheter aortic valve implantation - A Danish nationwide cohort study.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"International journal of cardiology. Heart & vasculature","doi":"10.1016/j.ijcha.2026.101981","source_url":"https://doi.org/10.1016/j.ijcha.2026.101981","authors":["Martha Meibom","Jeppe K Petersen","Victoria Mikkelsen","Louise Marqvard Sørensen","Jonas Agerlund Povlsen","Christian Juhl Terkelsen","Ashkan Eftekhari","Morten Schou","Lars Køber","Ole de Backer","Emil Fosbøl"],"significance":5,"published":"2026-08-21","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/antistolling-bij-ouderen/","https://hartvaat.nl/kennis/kleplijden/esc-richtlijn-kleplijden-2021/"],"congress":"","summary_en":"In a Danish nationwide cohort of 6,505 patients undergoing TAVI between 2015 and 2022, pre-procedural opioid use was associated with worse one-year outcomes compared to non-users. Opioid users had a significantly higher risk of all-cause mortality (10.4% vs 6.9%; adjusted HR 1.35) and increased hospitalization burden, with mortality rising in a dose-dependent manner. These findings highlight pre-procedural opioid use as an important prognostic marker in TAVI candidates, likely reflecting underlying comorbidities. Clinicians should consider this factor when assessing perioperative risk and planning post-procedural care.","created":"2026-08-15T00:52:59Z","updated":"2026-08-15T00:52:59Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een Deens nationaal cohort van 6505 patiënten die tussen 2015 en 2022 een TAVI ondergingen, vergeleken onderzoekers de uitkomsten van patiënten met en zonder voorgebruik van opioïden. Patiënten die opioïden gebruikten hadden een hoger risico op éénjarige sterfte (10,4% versus 6,9%; aHR 1,35) en een grotere ziekenhuisopnamebelasting, met een duidelijke dosis-responsrelatie. Deze bevindingen benadrukken dat voorgebruik van opioïden een belangrijke risicofactor is voor de perioperatieve prognose bij TAVI, waarschijnlijk mede door onderliggende aandoeningen. Voor cardiologen en behandelend specialisten betekent dit dat dit profiel extra aandacht vraagt bij risicobeoordeling en nazorg.","abstract_original":"BACKGROUND: Opioid use is frequently reported as a baseline characteristic in transcatheter aortic valve implantation (TAVI) cohorts, yet its prognostic implications have not been examined. AIM: To examine the association between pre-procedural opioid use and post-TAVI outcomes. METHODS: Using Danish nationwide registries, we identified patients undergoing TAVI between 2015 and 2022. Patients were categorized according to opioid use within one year before TAVI. We examined one-year all-cause mortality, cumulative days of hospitalization including the composite outcome of death or > 14 cumulative hospitalization days, and a potential opioid dose-response relationship. Adjusted relative risks were estimated using multivariable Cox and logistic regression. RESULTS: We identified 6505 patients: 1265 (19.4%) with opioid use (48.9% male; median age 80 years) and 5240 (80.6%) without (59.4% male; median age 81 years). The two groups were comparable in cardiac comorbidities and malignancy but differed in musculoskeletal (back disorders: 45.9% vs 20.7%; arthropathies 65.3% vs 47.1%) and psychiatric conditions (antidepressants: 18.8% vs. 9.6%; anxiolytics/hypnotics: 23.7% vs. 12.4%). Baseline opioid use was associated with higher post-TAVI mortality (10.4% vs 6.9%; adjusted HR 1.35, 95% CI 1.11-1.66) and increased risk of the composite outcome (OR 1.47, 95% CI 1.25-1.72). A dose-response relationship was observed, with one-year mortality increasing from 7.0% in non-users to 8.8% in low-dose users and 12.1% in high-dose users. CONCLUSION: Baseline opioid use was associated with increased mortality and hospitalization burden in the year following TAVI, and this relationship was aggravated among high-dose users. The observed associations were most likely driven by the underlying condition of the opioid therapy."}