Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysis
Background: Heart failure (HF) is a complex clinical syndrome with symptoms and signs that result from any structural or functional impairment of ventricular filling or ejection of blood. Limited data is available regarding the in-hospital outcomes of TAVR compared to SAVR in the octogenarian popula...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906722001683 |
| _version_ | 1798000849249632256 |
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| author | Yasar Sattar David Song Talal Almas Mohamed Zghouzi Usama Talib Abdul-Rahman M. Suleiman Bachar Ahmad Junaid Arshad Waqas Ullah Muhammad Zia Khan Christopher M. Bianco Rodrigo Bagur Muhammad Rashid Mamas A. Mamas M. Chadi Alraies |
| author_facet | Yasar Sattar David Song Talal Almas Mohamed Zghouzi Usama Talib Abdul-Rahman M. Suleiman Bachar Ahmad Junaid Arshad Waqas Ullah Muhammad Zia Khan Christopher M. Bianco Rodrigo Bagur Muhammad Rashid Mamas A. Mamas M. Chadi Alraies |
| author_sort | Yasar Sattar |
| collection | DOAJ |
| description | Background: Heart failure (HF) is a complex clinical syndrome with symptoms and signs that result from any structural or functional impairment of ventricular filling or ejection of blood. Limited data is available regarding the in-hospital outcomes of TAVR compared to SAVR in the octogenarian population with HF. Methods: The National Inpatient Sample (NIS) database was used to compare TAVR versus SAVR among octogenarians with HF. The primary outcome was in-hospital mortality. The secondary outcome included acute kidney injury (AKI), cerebrovascular accident (CVA), post-procedural stroke, major bleeding, blood transfusions, sudden cardiac arrest (SCA), cardiogenic shock (CS), and mechanical circulatory support (MCS). Results: A total of 74,995 octogenarian patients with HF (TAVR-HF n = 64,890 (86.5%); SAVR n = 10,105 (13.5%)) were included. The median age of patients in TAVR-HF and SAVR-HF was 86 (83–89) and 82 (81–84) respectively. TAVR-HF had lower percentage in-hospital mortality (1.8% vs. 6.9%;p < 0.001), CVA (2.5% vs. 3.6%; p = 0.009), SCA (9.9% vs. 20.2%; p < 0.001), AKI (17.4% vs. 40.8%); p < 0.001), major transfusion (26.4% vs 67.3%; p < 0.001), CS (1.8% vs 9.8%; p < 0.001), and MCS (0.8% vs 7.3%; p < 0.001) when compared to SAVR-HF. Additionally, post-procedural stroke and major bleeding showed no significant difference. The median unmatched total charges for TAVR-HF and SAVR-HF were 194,561$ and 246,100$ respectively. Conclusion: In this nationwide observational analysis, TAVR is associated with an improved safety profile for octogenarians with heart failure (both preserved and reduced ejection fraction) compared to SAVR. |
| first_indexed | 2024-04-11T11:26:55Z |
| format | Article |
| id | doaj.art-52e62a5a2e03486dbbb3142e89ab7450 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-11T11:26:55Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-52e62a5a2e03486dbbb3142e89ab74502022-12-22T04:26:15ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672022-10-0142101119Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysisYasar Sattar0David Song1Talal Almas2Mohamed Zghouzi3Usama Talib4Abdul-Rahman M. Suleiman5Bachar Ahmad6Junaid Arshad7Waqas Ullah8Muhammad Zia Khan9Christopher M. Bianco10Rodrigo Bagur11Muhammad Rashid12Mamas A. Mamas13M. Chadi Alraies14West Virginia University, Morgantown, WV, USAIcahn School of Medicine at Mount Sinai Elmhurst Hospital, Queens, NY, USARoyal College of Surgeons in Ireland, Dublin, Ireland; Corresponding authors at: Detroit Medical Center, 311 Mack Ave, Detroit, MI 48201, USA (M. Chadi Alraies) and Royal College of Surgeons in Ireland, Dublin, Ireland (T. Almas).Detroit Medical Center, Heart Hospital, Detroit, MI, USAUniverisry of Kentucky, Lexington, KY, USADetroit Medical Center, Heart Hospital, Detroit, MI, USADetroit Medical Center, Heart Hospital, Detroit, MI, USAInstitute of Medical Sciences, Islamabad, PakistanThomas Jefferson University, Philadelphia, PA, USAWest Virginia University, Morgantown, WV, USAWest Virginia University, Morgantown, WV, USALondon Health Sciences Centre, London, Ontario, CanadaKeele Cardiovascular Research Group, School of Medicine, Keele University, Stoke-on-Trent, UKKeele Cardiovascular Research Group, School of Medicine, Keele University, Stoke-on-Trent, UKDetroit Medical Center, Heart Hospital, Detroit, MI, USA; Corresponding authors at: Detroit Medical Center, 311 Mack Ave, Detroit, MI 48201, USA (M. Chadi Alraies) and Royal College of Surgeons in Ireland, Dublin, Ireland (T. Almas).Background: Heart failure (HF) is a complex clinical syndrome with symptoms and signs that result from any structural or functional impairment of ventricular filling or ejection of blood. Limited data is available regarding the in-hospital outcomes of TAVR compared to SAVR in the octogenarian population with HF. Methods: The National Inpatient Sample (NIS) database was used to compare TAVR versus SAVR among octogenarians with HF. The primary outcome was in-hospital mortality. The secondary outcome included acute kidney injury (AKI), cerebrovascular accident (CVA), post-procedural stroke, major bleeding, blood transfusions, sudden cardiac arrest (SCA), cardiogenic shock (CS), and mechanical circulatory support (MCS). Results: A total of 74,995 octogenarian patients with HF (TAVR-HF n = 64,890 (86.5%); SAVR n = 10,105 (13.5%)) were included. The median age of patients in TAVR-HF and SAVR-HF was 86 (83–89) and 82 (81–84) respectively. TAVR-HF had lower percentage in-hospital mortality (1.8% vs. 6.9%;p < 0.001), CVA (2.5% vs. 3.6%; p = 0.009), SCA (9.9% vs. 20.2%; p < 0.001), AKI (17.4% vs. 40.8%); p < 0.001), major transfusion (26.4% vs 67.3%; p < 0.001), CS (1.8% vs 9.8%; p < 0.001), and MCS (0.8% vs 7.3%; p < 0.001) when compared to SAVR-HF. Additionally, post-procedural stroke and major bleeding showed no significant difference. The median unmatched total charges for TAVR-HF and SAVR-HF were 194,561$ and 246,100$ respectively. Conclusion: In this nationwide observational analysis, TAVR is associated with an improved safety profile for octogenarians with heart failure (both preserved and reduced ejection fraction) compared to SAVR.http://www.sciencedirect.com/science/article/pii/S2352906722001683Transcatheter aortic valve replacementSurgical aortic valve replacementHeart failureHeart Failure with reduced ejection fractionHeart Failure with preserved ejection fraction |
| spellingShingle | Yasar Sattar David Song Talal Almas Mohamed Zghouzi Usama Talib Abdul-Rahman M. Suleiman Bachar Ahmad Junaid Arshad Waqas Ullah Muhammad Zia Khan Christopher M. Bianco Rodrigo Bagur Muhammad Rashid Mamas A. Mamas M. Chadi Alraies Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysis International Journal of Cardiology: Heart & Vasculature Transcatheter aortic valve replacement Surgical aortic valve replacement Heart failure Heart Failure with reduced ejection fraction Heart Failure with preserved ejection fraction |
| title | Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysis |
| title_full | Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysis |
| title_fullStr | Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysis |
| title_full_unstemmed | Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysis |
| title_short | Cardiovascular outcomes and trends of Transcatheter vs. Surgical aortic valve replacement among octogenarians with heart failure: A Propensity Matched national cohort analysis |
| title_sort | cardiovascular outcomes and trends of transcatheter vs surgical aortic valve replacement among octogenarians with heart failure a propensity matched national cohort analysis |
| topic | Transcatheter aortic valve replacement Surgical aortic valve replacement Heart failure Heart Failure with reduced ejection fraction Heart Failure with preserved ejection fraction |
| url | http://www.sciencedirect.com/science/article/pii/S2352906722001683 |
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