{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:10:13Z","timestamp":1790291413605,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The present population\u2010based cohort study investigated long\u2010term mortality after surgical aortic valve replacement (AVR) with bioprosthetic (B) or mechanical aortic valve prostheses (M) in a European social welfare state.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed patient data from health insurance records covering 98% of the Austrian population between 2010 and 2018. Subsequent patient\u2010level record linkage with national health data provided patient characteristics and clinical outcomes. Further reoperation, myocardial infarction, heart failure and stroke were evaluated as secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 13,993 patients were analysed and the following age groups were examined separately: &lt;50\u00a0years (727 patients: 57.77% M, 42.23% B), 50\u201365\u00a0years (2612 patients: 26.88% M, 73.12% B) and &gt;65\u00a0years (10,654 patients: 1.26% M, 98.74% B). Multivariable Cox regression revealed that the use of B\u2010AVR was significantly associated with higher mortality in patients aged 50\u201365\u00a0years compared to M\u2010AVR (HR\u00a0=\u00a01.676 [1.289\u20132.181], <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). B\u2010AVR also performed worse in a competing risk analysis regarding reoperation (HR\u00a0=\u00a03.483 [1.445\u20138.396], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.005) and myocardial infarction (HR\u00a0=\u00a02.868 [1.255\u20136.555], <jats:italic>p<\/jats:italic>\u00a0=\u00a00.012). However, the risk of developing heart failure and stroke did not differ significantly after AVR in any age group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients aged 50\u201365\u00a0years who underwent M\u2010AVR had better long\u2010term survival, and a lower risk of reoperation and myocardial infarction. Even though anticoagulation is crucial in patients with M\u2010AVR, we did not observe significantly increased stroke rates in patients with M\u2010AVR. This evident survival benefit in recipients of mechanical aortic valve prostheses aged &lt;65\u00a0years critically questions current guideline recommendations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13736","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T15:43:00Z","timestamp":1640101380000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Mechanical aortic valve prostheses offer a survival benefit in 50\u201365\u00a0year olds: AUTHEARTVISIT study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8679-1525","authenticated-orcid":false,"given":"Denise","family":"Traxler","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine II Medical University of Vienna  Vienna Austria"},{"name":"Laboratory for Cardiac and Thoracic Diagnosis, Regeneration and Applied Immunology  Vienna 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