Impact of Cancer in Patients Undergoing Transcatheter Aortic Valve Replacement: A Single-Center Study

Autor:	Alexander, Lind, Matthias, Totzeck, Amir A, Mahabadi, Rolf A, Jánosi, Mohamed, El Gabry, Arjang, Ruhparwar, Simone M, Mrotzek, Lena, Hinrichs, Merve, Akdeniz, Tienush, Rassaf, Raluca I, Mincu
Rok vydání:	2020
Předmět:	treatment planning TAVR transcatheter aortic valve replacement aortic stenosis valvular disease outcomes SC stable cancer STS Society of Thoracic Surgeons risk prediction AC active cancer cancer transcatheter aortic valve replacement guidelines NYHA New York Heart Association Original Research
Zdroj:	JACC: CardioOncology
ISSN:	2666-0873
Popis:	Background The use of transcatheter aortic valve replacement (TAVR) in cancer survivors and patients with active cancer (AC) in cancer survivors and patients with active cancer (AC) is expanding, suggesting a need to adjust the indications and risk assessment pre-TAVR. Objectives The purpose of this study was to determine the impact of cancer on peri-procedural complications and survival in a long-term, single-center cohort of patients treated with TAVR. Methods Patients treated with TAVR between January 2006 and December 2018 were grouped as follows: controls (patients without cancer), stable cancer (SC), and AC. The primary endpoints were peri-procedural complications and 30-day survival. A secondary endpoint was 10-year survival. Results A total of 1,088 patients (age 81 ± 5 years, 46.6% men) treated with transfemoral TAVR were selected: 839 controls, 196 SC, and 53 AC. Predominant malignancies were breast, gastrointestinal, and prostate cancer. No differences were observed between patients with cancer and controls regarding peri-procedural complications. Patients with AC had similar 30-day survival compared with controls and SC (94.3% vs. 93.3% vs. 96.9%, p = 0.161), but as expected, reduced 10-year survival. AC was associated with a 1.47 (95% CI 1.16 to 1.87) fold increased risk of all-cause 10-year mortality in multivariable adjusted models. Conclusions TAVR should be performed in patients with cancer when indicated, considering that patients with cancer have similar periprocedural complications and short-term survival compared with control patients. However, patients with AC have worse 10-year survival. Future studies are needed to define cancer-specific determinants of worse long-term survival. Central Illustration
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::e7b746db43da554a5906145c6089a057 https://pubmed.ncbi.nlm.nih.gov/34396288 Zobrazit plný text záznamu