Frequency of and Prognostic Significance of Atrial Fibrillation in Patients Undergoing Transcatheter Aortic Valve Implantation

Autor: Anna Sannino, Paul A. Grayburn, Michael J. Mack, A.Carl Henry, Molly Szerlip, Ravi C. Vallabhan, Robert C. Stoler, David L. Brown, Brian Lima, Robert C. Kowal
Přispěvatelé: Sannino, A., Stoler, R. C., Lima, B., Szerlip, M., Henry, A. C., Vallabhan, R., Kowal, R. C., Brown, D. L., Mack, M. J., Grayburn, P. A.
Rok vydání: 2016
Předmět:
Male
Time Factors
030204 cardiovascular system & hematology
Electrocardiography
Postoperative Complications
0302 clinical medicine
Retrospective Studie
Risk Factors
Cause of Death
Atrial Fibrillation
Prevalence
Sinus rhythm
030212 general & internal medicine
Stroke
Aged
80 and over
medicine.diagnostic_test
Incidence
Incidence (epidemiology)
Mortality rate
Hazard ratio
Atrial fibrillation
Prognosis
Texas
Survival Rate
Aortic Valve
Cardiology
Female
Texa
Cardiology and Cardiovascular Medicine
Human
medicine.medical_specialty
Time Factor
Prognosi
Follow-Up Studie
Transcatheter Aortic Valve Replacement
03 medical and health sciences
Internal medicine
medicine
Humans
Retrospective Studies
business.industry
Risk Factor
Retrospective cohort study
Aortic Valve Stenosis
medicine.disease
Aortic Valve Stenosi
Surgery
Postoperative Complication
business
Follow-Up Studies
Zdroj: The American Journal of Cardiology. 118:1527-1532
ISSN: 0002-9149
Popis: The prognostic implications of preexisting atrial fibrillation (AF) and new-onset AF (NOAF) in transcatheter aortic valve implantation (TAVI) remain uncertain. This study assesses the epidemiology of AF in patients treated with TAVI and evaluates their outcomes according to the presence of preexisting AF or NOAF. A retrospective analysis of 708 patients undergoing TAVI from 2 heart hospitals was performed. Patients were divided into 3 study groups: sinus rhythm (n = 423), preexisting AF (n = 219), and NOAF (n = 66). Primary outcomes of interest were all-cause death and stroke both at 30-day and at 1-year follow-up. Preexisting AF was present in 30.9% of our study population, whereas NOAF was observed in 9.3% of patients after TAVI. AF and NOAF patients showed a higher rate of 1-year all-cause mortality compared with patients in sinus rhythm (14.6% vs 6.5% for preexisting AF and 16.3% vs 6.5% for NOAF, p = 0.007). No differences in 30-day mortality were observed between groups. In patients with AF (either preexisting and new-onset), those discharged with single antiplatelet therapy displayed higher mortality rates at 1 year (42.9% vs 11.7%, p = 0.006). Preexisting AF remained an independent predictor of mortality at 1-year follow-up (hazard ratio [HR] 2.34, 95% CI 1.22 to 4.48, p = 0.010). Independent predictors of NOAF were transapical and transaortic approach as well as balloon postdilatation (HR 3.48, 95% CI 1.66 to 7.29, p = 0.001; HR 5.08, 95% CI 2.08 to 12.39, p
Databáze: OpenAIRE
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