Outcomes of Transcatheter Aortic Valve Implant Among Patients With A Previous Coronary Artery Bypass Graft: A Nationwide Analysis.

Autor: Abumoawad A; Division of Cardiovascular Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts., Afify H; Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky., Saleh M; Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas., Obaed N; Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania., Jneid H; Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas., Khalife WI; Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas., Kumbhani DJ; Division of Cardiovascular Medicine, University of Texas Southwestern Medical Center, Dallas, Texas., Elbadawi A; Division of Cardiovascular Medicine, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: aymangalal24@hotmail.com.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2023 Sep 01; Vol. 202, pp. 210-217. Date of Electronic Publication: 2023 Jul 18.
DOI: 10.1016/j.amjcard.2023.06.064
Abstrakt: There is a paucity of data regarding the temporal trends and outcomes of transcatheter aortic valve implant (TAVI) among patients with a previous coronary artery bypass graft (CABG) surgery. We queried the Nationwide Readmissions Database (2016 to 2019) for hospitalized patients who underwent TAVI using the appropriate International Classification of Diseases, Tenth Revision procedural codes. A multivariable regression analysis was used to adjust for the patients' and hospitals' characteristics in comparing the study groups. The primary outcome was in-hospital mortality. The final analysis included 237,829 patients who underwent TAVI, of whom 42,671 (17.9%) had a previous CABG. During the study period, there was a decrease in the proportion of patients with previous CABG who underwent TAVI (21.0% in 2016 vs 15.5% in 2019, p trend  = 0.01), although there was no change in their in-hospital mortality rate (1.08% in 2016 vs 1.25% in 2019, p trend  = 0.43). Patients with a previous CABG were younger and less likely to be women than those without a previous CABG. TAVI among those with a previous CABG was associated with lower in-hospital mortality (adjusted odds ratio [aOR] 0.79, 95% confidence interval [CI] 0.69 to 0.91), similar rate of ischemic stroke (aOR 0.81, 95% CI 0.71 to 0.93) and permanent pacemaker implant (aOR 1.00, 95% CI 0.93 to 1.05). Patients with a previous CABG had a lower all-cause 90-day readmission (odds ratio 0.95, 95% CI 0.94 to 1.06) but higher readmission for transient ischemic attack. Among those with a previous CABG, female gender and chronic kidney disease stage ≥3 were independently associated with a higher in-hospital mortality, whereas obesity was associated with a lower in-hospital mortality. In conclusion, there was a decrease in the proportion of patients with a previous CABG among those who underwent TAVI. TAVI among those with a previous CABG was not associated with increased in-hospital adverse events or 90-day all-cause readmissions.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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