Risk factors for early mortality following transcatheter edge-to-edge repair of mitral regurgitation.

Autor: Yeo YH; Department of Internal Medicine-Pediatrics, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA., Thong JY; Shanghai Medical College, Fudan University, China., Tan MC; Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA; Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA., Ang QX; Department of Internal Medicine, Sparrow Health System and Michigan State University, East Lansing, MI, USA., San BJ; AIMST University, Malaysia., Tan BE; Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA., Chatterjee A; Department of Cardiovascular Medicine, University of Arizona, Tucson, AZ, USA., Lee K; Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA. Electronic address: Lee.kwan@mayo.edu.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2024 Aug 15. Date of Electronic Publication: 2024 Aug 15.
DOI: 10.1016/j.carrev.2024.08.001
Abstrakt: Background: While transcatheter edge-to-edge repair (TEER) with MitraClip is increasingly used, data on the risk stratification for assessing early mortality after this procedure are scarce.
Objective: This study aimed to assess early mortality and analyze the risk factors of early mortality among patients who underwent TEER.
Methods: Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged 18 years or older who had TEER between January 2017 and November 2020. We categorized the cohort into two groups depending on the occurrence of early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of early mortality after TEER and further analyzed the risk factors associated with early mortality.
Results: A total of 15,931 patients who had TEER were included; 292 (1.8 %) with early mortality and 15,639 (98.2 %) without. There was a decreasing trend in early mortality from 2.8 % in the first quarter of 2017 to 1.2 % in the fourth quarter of 2020, but it was not statistically significant (p = 0.18). In multivariable analysis, the independent risk factors for early mortality were chronic kidney disease not requiring dialysis (adjusted odds ratio [aOR]: 1.57; 95 % confidence interval [CI]: 1.11-2.22, p = 0.01), end-stage renal disease (aOR: 2.34; CI: 1.44-3.79, p < 0.01), chronic liver disease (aOR: 4.90; CI: 3.29-7.29, p < 0.01), coagulation disorder (aOR: 3.42; CI: 2.35-5.03, p < 0.01), systolic heart failure (aOR: 2.81; CI: 1.34-5.90, p < 0.01), diastolic heart failure (aOR: 2.69; CI: 1.24-5.84, p = 0.01) and unspecified heart failure (aOR: 3.23; CI: 1.49-7.01, p < 0.01). Among those who died during 30-day readmission following TEER, the most common cardiac cause and non-cardiac-cause of readmission were heart failure (18.2 %) and infection (26.6 %), respectively.
Conclusion: The early mortality following TEER was low at 1.8 %. The independent risk factors associated with early mortality were chronic kidney disease (including end-stage renal disease), chronic liver disease, coagulation disorder, and heart failure (both systolic and diastolic).
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 © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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