Systolic Heart Failure is Associated with Higher Mortality Among Patients Undergoing Transcatheter Aortic Valve Replacement: A Nationwide Analysis.

Autor: Fatuyi M; Department of Medicine, TriHealth Good Samaritan Hospital Program, Cincinnati, OH. Electronic address: michaelfatuyi@gmail.com., Akinti S; Department of Medicine, Brookdale University Hospital, medical center, Queens, NY., Rukayat O; Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD., Md NA; TriHealth Heart and Vascular Institute, Cincinnati, OH., Ansari A; TriHealth Heart and Vascular Institute, Cincinnati, OH., Al-Amoodi M; TriHealth Heart and Vascular Institute, Cincinnati, OH., Chung ES; Heart and Vascular Institute, The Christ Hospital Health Network. Cincinnati, OH., Shemisa K; TriHealth Heart and Vascular Institute, Cincinnati, OH.
Jazyk: angličtina
Zdroj: Current problems in cardiology [Curr Probl Cardiol] 2023 Dec; Vol. 48 (12), pp. 101936. Date of Electronic Publication: 2023 Jul 09.
DOI: 10.1016/j.cpcardiol.2023.101936
Abstrakt: Heart failure (HF) is prevalent among patients with aortic stenosis and presents a poor prognosis. In order to better portray outcomes for HF patients undergoing transcatheter aortic valve replacement (TAVR), we evaluated clinical outcomes in patients with systolic vs diastolic heart failure who underwent TAVR in a large nationwide database. We searched the National Inpatient Sample (NIS) for hospitalized adult patients who underwent TAVR with coexisting history of systolic (SHF) or diastolic heart failure (DHF) as a secondary diagnosis using the ICD-10 codes. The primary outcome was in-hospital mortality, with secondary outcomes of cardiac arrest (CA), cardiogenic shock (CS), respiratory failure (RF), Non-ST elevation myocardial infarction (NSTEMI), acute kidney injury (AKI), use of cardiac and respiratory assist device, and health care utilization defined as length of stay, average hospital cost (AHC) and patient charge (APC). Both univariate and multivariate logistic, generalized linear, and Poisson regression analyses were used to evaluate and test the outcomes. A P-value of <0.05 was significant. A total of 106,815 patients were admitted to acute care hospitals for TAVR, and 73% had a secondary diagnosis of heart failure (41% had SHF and 59% DHF). SHF group were older (mean age of 78.9 years [SD ± 8.9] vs 79.9 years [SD ± 8.3]) with more males (61.8% vs 48.2%) and white predominant (whites [85.9% vs 87.9%]). Compared to DHF, SHF had higher inpatient mortality (1.75% vs 1.14%, P = 0.003), CA (1.31% vs 0.81%, P = 0.01), NSTEMI (2.52% vs 1.0%, P = 0.001), RF (10.87% vs 8.01%, P = 0.001), and CS (3.94% vs 1.14%, P = 0.001). In addition, SHF had greater LOS (5.1 days vs. .3.9, P = 0.0001) & AHC ($52,901 vs $48,070, P = 0.0001). HF is common among patients admitted for TAVR. SHF had worse CV outcomes, greater use of hospital resources, and higher acute care hospital mortality compared to those with DHF.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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