Temporal trends and outcomes in utilisation of transcatheter and surgical aortic valve therapies in aortic valve stenosis patients with heart failure. Int J Clin Pract 2021 Mar;75(3):e13711
Date
09/22/2020Pubmed ID
32955776DOI
10.1111/ijcp.13711Scopus ID
2-s2.0-85098149748 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
INTRODUCTIONS & AIMS: Heart failure (HF) is a common comorbidity in patients undergoing surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). We sought to access the temporal trends and outcomes of TAVR or SAVR in HF patients.
METHOD: The NIS database from 2011-2014 was queried for patients that underwent TAVR or SAVR and were subsequently diagnosed with HF. Temporal trends in the utilisation of TAVR or SAVR in HF patients were analysed.
RESULTS: Among 27 982 patients who were diagnosed with HF of whom 17 681 (63.2%) had heart failure with reduced ejection fraction (HFrEF) while 10 301 (36.8%) had heart failure with preserved ejection fraction (HFpEF), 9049 (32.3%) underwent TAVR and 16 933 (76.7%) underwent SAVR. Patients with HFrEF and HFpEF had higher utilisation of TAVR compared with SAVR over the course of the study period (P trend < .001). TAVR was associated with lower mortality [2.8% in 2012 and 1.8% in 2014 (P .013)] compared with SAVR. Similarly, multiple logistic regression showed a statistically significant lower in-hospital mortality in the TAVR group compared with SAVR (aOR 0.634; CI 0.504, 0.798, P < .001).
CONCLUSION: For patients with severe aortic valve stenosis and heart failure who undergo aortic valve intervention, TAVR is associated with less odds of in-hospital mortality compared with SAVR.
Author List
Al-Khadra Y, Sattar Y, Ullah W, Moussa Pacha H, Baibars M, Darmoch F, Abu-Mahfouz M, Afonso L, Devireddy C, Anwaruddin S, Sorajja P, Ajmal R, Kwok CS, Asfour AI, Zehr K, Mamas MA, Alraies MCAuthor
Saif Anwaruddin MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Aortic ValveAortic Valve Stenosis
Heart Failure
Heart Valve Prosthesis Implantation
Humans
Risk Factors
Stroke Volume
Treatment Outcome