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Outcomes of Transcatheter Aortic Valve Implantation in Patients With Chronic and End-Stage Kidney Disease.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2022 Feb 01; Vol. 164, pp. 100-102. Date of Electronic Publication: 2021 Nov 23. - Publication Year :
- 2022
-
Abstract
- Patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are at higher risk of aortic stenosis. Data regarding transcatheter aortic valve implantation (TAVI) in these patients are limited. Herein, we aim to investigate TAVI outcomes in patients with ESKD and CKD. We analyzed clinical data of patients with ESKD and CKD who underwent TAVI from 2008 to 2018 in a large urban healthcare system. Patients' demographics were compared, and significant morbidity and mortality outcomes were noted. Multivariable analyses were used to adjust for potential baseline variables. A total of 643 patients with CKD underwent TAVI with an overall in-hospital mortality of 5.1%, whereas 84 patients with ESKD underwent TAVI with an overall mortality rate of 11.9%. The most frequently observed comorbidities in patients with CKD were heart failure, atrial fibrillation (AF), mitral stenosis (MS), pulmonary hypertension, and chronic lung disease. After multivariable analysis, MS (adjusted odds ratio (OR) 3.92; 95% confidence interval (CI) 1.09 to 11.1, p <0.05) and AF (adjusted OR 2.42; 95% CI 1.3 to 4.4 p <0.05) were independently associated with mortality in patients with CKD. The most common comorbidities observed in patients with ESKD undergoing TAVI were heart failure, chronic lung disease, AF, MS, and pulmonary hypertension. An association between MS and increased mortality was observed (adjusted OR 2.01; 95 CI 0.93 to 2.02, p = 0.09) in patients with ESKD, but was not statistically significant. In conclusion, in patients with CKD undergoing TAVI, AF and MS were independently associated with increased mortality.<br />Competing Interests: Disclosures The authors have no conflicts of interest to declare.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Aortic Valve Stenosis epidemiology
Atrial Fibrillation epidemiology
Comorbidity
Female
Heart Failure epidemiology
Humans
Hypertension, Pulmonary epidemiology
Logistic Models
Male
Mitral Valve Stenosis epidemiology
Multivariate Analysis
Pulmonary Disease, Chronic Obstructive epidemiology
Transcatheter Aortic Valve Replacement
Treatment Outcome
Aortic Valve Stenosis surgery
Hospital Mortality
Kidney Failure, Chronic epidemiology
Renal Insufficiency, Chronic epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 164
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 34823840
- Full Text :
- https://doi.org/10.1016/j.amjcard.2021.10.039