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Background <p>Hematopoietic clonal disorders have previously been associated with cardiac diseases. Higher incidences of aortic valve stenosis have been observed not only in clonal hematopoiesis of indeterminate potential (CHIP) but also in monoclonal gammopathy of unknown significance (MGUS). However, studies investigating the outcome after transcatheter aortic valve implantation (TAVI) in MGUS are lacking.</p> Objective <p>Investigate overall survival in MGUS patients after TAVI.</p> Methods <p>We used the federated real-world data platform TriNetX to identify MGUS patients undergoing TAVI. Patients were divided into cohorts based on presence of MGUS, age or comorbidities and matched using the TriNetX propensity score matching tool. Overall survival was assessed after 1, 3 and 5 years.</p> Results <p>We identified 58,796 patients with TAVI procedure. Of these, 1039 patients (1.8%) were identified with co-occurring MGUS. Our study shows superior overall survival for patients without MGUS after TAVI in the overall cohort (HR:0.792 CI95% 0.657, 0.954, <i>p</i> = 0.014) and &gt; 75 years of age (HR:0.797, CI95% 0.660, 0.961, <i>p</i> = 0.017) at the 5-year timepoint. 5-year overall survival did not differ in younger MGUS patients (&lt; 75 years) or patients with co-occurring chronic kidney disease, chronic obstructive pulmonary disease or heart failure (<i>p</i> &gt; 0.05).</p> Conclusion <p>In this real-world analysis in patients with MGUS undergoing TAVI, MGUS was associated with inferior outcomes after TAVI, especially for older (&gt; 75 years) patients. Five-year overall survival did not differ among patients with common comorbidities. Our results suggest that MGUS may be linked to worse overall long-term survival following TAVI and highlights the need for further interdisciplinary cardiooncology research. Given the key methodological limitations, the present results should be considered as hypothesis-generating.</p>

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Survival in patients with monoclonal gammopathy of unknown significance after transcatheter aortic valve replacement: a global retrospective propensity-matched real-world analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月20日

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  • Lorenz Oelschläger,
  • Dominik Rebafka,
  • Christian Frerker,
  • Thomas Stiermaier,
  • Jan Morf,
  • Jan Vorwerk,
  • Anna Traub,
  • Theo Leitner,
  • Nikolas von Bubnoff,
  • Cyrus Khandanpour,
  • Ingo Eitel

摘要

Background

Hematopoietic clonal disorders have previously been associated with cardiac diseases. Higher incidences of aortic valve stenosis have been observed not only in clonal hematopoiesis of indeterminate potential (CHIP) but also in monoclonal gammopathy of unknown significance (MGUS). However, studies investigating the outcome after transcatheter aortic valve implantation (TAVI) in MGUS are lacking.

Objective

Investigate overall survival in MGUS patients after TAVI.

Methods

We used the federated real-world data platform TriNetX to identify MGUS patients undergoing TAVI. Patients were divided into cohorts based on presence of MGUS, age or comorbidities and matched using the TriNetX propensity score matching tool. Overall survival was assessed after 1, 3 and 5 years.

Results

We identified 58,796 patients with TAVI procedure. Of these, 1039 patients (1.8%) were identified with co-occurring MGUS. Our study shows superior overall survival for patients without MGUS after TAVI in the overall cohort (HR:0.792 CI95% 0.657, 0.954, p = 0.014) and > 75 years of age (HR:0.797, CI95% 0.660, 0.961, p = 0.017) at the 5-year timepoint. 5-year overall survival did not differ in younger MGUS patients (< 75 years) or patients with co-occurring chronic kidney disease, chronic obstructive pulmonary disease or heart failure (p > 0.05).

Conclusion

In this real-world analysis in patients with MGUS undergoing TAVI, MGUS was associated with inferior outcomes after TAVI, especially for older (> 75 years) patients. Five-year overall survival did not differ among patients with common comorbidities. Our results suggest that MGUS may be linked to worse overall long-term survival following TAVI and highlights the need for further interdisciplinary cardiooncology research. Given the key methodological limitations, the present results should be considered as hypothesis-generating.