Systemic Corticosteroid Exposure and Atrioventricular Conductance Delays After Transcatheter Aortic Valve Implantation
| Autor: | Tobias Reichlin, Fabien Praz, Benedikt Bernhard, Stephan Windecker, Taishi Okuno, Jonas Lanz, Thomas Pilgrim, Stefan Stortecky, Aleksandar Cicovic |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Bundle-Branch Block Ischemia Autopsy 610 Medicine & health Transcatheter Aortic Valve Replacement Internal medicine medicine Clinical endpoint Humans Prospective Studies Lead (electronics) Aged Retrospective Studies Aged 80 and over Inflammation Left bundle branch block business.industry Arrhythmias Cardiac General Medicine Aortic Valve Stenosis medicine.disease Treatment Outcome Aortic Valve Heart Valve Prosthesis Cohort Propensity score matching Cardiology Corticosteroid Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Bernhard, Benedikt; Okuno, Taishi; Cicovic, Aleksandar; Stortecky, Stefan; Reichlin, Tobias; Lanz, Jonas; Praz, Fabien; Windecker, Stephan; Pilgrim, Thomas (2022). Systemic corticosteroid exposure and atrioventricular conductance delays after transcatheter aortic valve implantation. Cardiovascular revascularization medicine, 37, pp. 1-6. Elsevier 10.1016/j.carrev.2021.06.127 |
| ISSN: | 1878-0938 |
| DOI: | 10.1016/j.carrev.2021.06.127 |
| Popis: | Background Atrioventricular conduction delays (AVCD) are common after transcatheter aortic valve implantation (TAVI) and frequently require implantation of a permanent pacemaker (PPM). Autopsy studies demonstrated the role of ischemia, inflammation, and oedema in the pathogenesis of AVCD. Corticosteroids (CS) reduce inflammation and oedema and hence might lead to a lower rate of AVCD. Methods Based on a prospective single-center registry, we performed a propensity score (PS) matched analysis of subjects treated with or without systemic CS (>2.5 mg prednisolone-equivalent per day) at the time of TAVI. The primary endpoint was a composite of PPM-implantation and new-onset left bundle branch block (LBBB) within 30 days after TAVI. Results Among 2213 consecutive patients undergoing TAVI (51.5% female, mean age 82.1 ± 6.1 years) 89 patients were treated with systemic CS, of which 87 were included in the PS matched analysis. At 30 days, rates of the composite of PPM and LBBB were comparable between patients with versus without CS both in the overall cohort (33.7% versus 33.0%, p = 0.89) and the PS matched cohort (34.5% versus 40.2%, p = 0.443). There were no differences in a composite of major or minor vascular complications and major or life-threatening bleeding events between patients with versus without CS in the overall cohort (34.8% versus 26.6%, p = 0.088) or the PS matched cohort (33.3% versus 33.3%, p ≥ 0.999). Conclusion In this exploratory study, intake of systemic CS among patients undergoing TAVI was not associated with differences in rates of AVCD, vascular complications, or bleeding events after TAVI. |
| Databáze: | OpenAIRE |
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