The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacement
Aims: Patients undergoing aortic valve replacement (AVR) for severe aortic stenosis have a 6–16% prevalence of occult cardiac amyloidosis. Carpal tunnel syndrome (CTS) is common in cardiac amyloidosis, but whether prior CTS surgery has a prognostic impact in patients undergoing AVR is unknown. This...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-04-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906721000294 |
| _version_ | 1818737067831590912 |
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| author | Oscar Westin Marie D. Lauridsen Søren Lund Kristensen Lars Køber Christian Torp-Pedersen Gunnar Gislason Lars Søndergaard Mathew S. Maurer Birgitte Pernille Leicht Finn Gustafsson Emil L. Fosbøl |
| author_facet | Oscar Westin Marie D. Lauridsen Søren Lund Kristensen Lars Køber Christian Torp-Pedersen Gunnar Gislason Lars Søndergaard Mathew S. Maurer Birgitte Pernille Leicht Finn Gustafsson Emil L. Fosbøl |
| author_sort | Oscar Westin |
| collection | DOAJ |
| description | Aims: Patients undergoing aortic valve replacement (AVR) for severe aortic stenosis have a 6–16% prevalence of occult cardiac amyloidosis. Carpal tunnel syndrome (CTS) is common in cardiac amyloidosis, but whether prior CTS surgery has a prognostic impact in patients undergoing AVR is unknown. This study examined the association between prior CTS surgery and adverse cardiovascular outcomes in patients treated with AVR. Methods and results: Using Danish nationwide registries, we retrospectively identified patients undergoing first-time AVR from 2005 to 2018, examining the association between previous CTS and adverse cardiovascular outcomes the following 5 years after the AVR procedure. Cumulative incidence functions and adjusted Cox proportional hazard models were used to assess differences. Among 19,211 patients undergoing AVR, 2.5% (n = 472) had prior CTS surgery. Patients in the CTS-cohort were significantly older (median age 75.7 [IQR 68.1–82.3] vs 73.7 [IQR 66.0–79.6]), more often female and had more comorbidities. Prior CTS surgery was not associated with differences in hospitalization for heart failure (11.2% [95% CI 8.3–14.7] vs 9.4% [95% CI 9.0–9.9]), atrial fibrillation (11.1% [95% CI 8.2–14.5] vs 11.2% [95% CI 10.8–11.7]) or pacemaker implantation (6.2% [95% CI 4.0–9.0] vs 5.1% [95% CI 4.8–5.5]). The 5-year mortality (32.8% [27.6–38.0] vs 25.2% [24.5–25.9]) was higher in the CTS-cohort. CTS was significantly associated with increased 5-year mortality (HR 1.27 [1.05–1.53]) in crude models, however, after multivariable adjustment prior CTS surgery was not associated with adverse cardiovascular outcomes. Conclusion: Previous CTS surgery was not associated with increased risk for adverse cardiovascular outcomes after AVR. |
| first_indexed | 2024-12-18T00:47:09Z |
| format | Article |
| id | doaj.art-fadafb4d77834734a2ee4a09e9e6f0c0 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-18T00:47:09Z |
| publishDate | 2021-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-fadafb4d77834734a2ee4a09e9e6f0c02022-12-21T21:26:46ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672021-04-0133100741The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacementOscar Westin0Marie D. Lauridsen1Søren Lund Kristensen2Lars Køber3Christian Torp-Pedersen4Gunnar Gislason5Lars Søndergaard6Mathew S. Maurer7Birgitte Pernille Leicht8Finn Gustafsson9Emil L. Fosbøl10The Heart Center, University Hospital of Copenhagen, Rigshospitalet, Denmark; Corresponding author at: Hjertemedicinsk Klinik, 2142, Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark.The Heart Center, University Hospital of Copenhagen, Rigshospitalet, DenmarkThe Heart Center, University Hospital of Copenhagen, Rigshospitalet, DenmarkThe Heart Center, University Hospital of Copenhagen, Rigshospitalet, DenmarkDepartment of Cardiology and Clinical Research, Nordsjællands Hospital, Hillerød, DenmarkDepartment of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Denmark; The Danish Heart Foundation, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; The National Institute of Public Health, University of Southern Denmark, Copenhagen, DenmarkThe Heart Center, University Hospital of Copenhagen, Rigshospitalet, DenmarkColumbia University Irving Medical Center, New York, NY, United StatesGildhøj Privathospital, Copenhagen, DenmarkThe Heart Center, University Hospital of Copenhagen, Rigshospitalet, DenmarkThe Heart Center, University Hospital of Copenhagen, Rigshospitalet, DenmarkAims: Patients undergoing aortic valve replacement (AVR) for severe aortic stenosis have a 6–16% prevalence of occult cardiac amyloidosis. Carpal tunnel syndrome (CTS) is common in cardiac amyloidosis, but whether prior CTS surgery has a prognostic impact in patients undergoing AVR is unknown. This study examined the association between prior CTS surgery and adverse cardiovascular outcomes in patients treated with AVR. Methods and results: Using Danish nationwide registries, we retrospectively identified patients undergoing first-time AVR from 2005 to 2018, examining the association between previous CTS and adverse cardiovascular outcomes the following 5 years after the AVR procedure. Cumulative incidence functions and adjusted Cox proportional hazard models were used to assess differences. Among 19,211 patients undergoing AVR, 2.5% (n = 472) had prior CTS surgery. Patients in the CTS-cohort were significantly older (median age 75.7 [IQR 68.1–82.3] vs 73.7 [IQR 66.0–79.6]), more often female and had more comorbidities. Prior CTS surgery was not associated with differences in hospitalization for heart failure (11.2% [95% CI 8.3–14.7] vs 9.4% [95% CI 9.0–9.9]), atrial fibrillation (11.1% [95% CI 8.2–14.5] vs 11.2% [95% CI 10.8–11.7]) or pacemaker implantation (6.2% [95% CI 4.0–9.0] vs 5.1% [95% CI 4.8–5.5]). The 5-year mortality (32.8% [27.6–38.0] vs 25.2% [24.5–25.9]) was higher in the CTS-cohort. CTS was significantly associated with increased 5-year mortality (HR 1.27 [1.05–1.53]) in crude models, however, after multivariable adjustment prior CTS surgery was not associated with adverse cardiovascular outcomes. Conclusion: Previous CTS surgery was not associated with increased risk for adverse cardiovascular outcomes after AVR.http://www.sciencedirect.com/science/article/pii/S2352906721000294Carpal tunnel syndromeAortic valve replacementCardiac amyloidosis |
| spellingShingle | Oscar Westin Marie D. Lauridsen Søren Lund Kristensen Lars Køber Christian Torp-Pedersen Gunnar Gislason Lars Søndergaard Mathew S. Maurer Birgitte Pernille Leicht Finn Gustafsson Emil L. Fosbøl The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacement International Journal of Cardiology: Heart & Vasculature Carpal tunnel syndrome Aortic valve replacement Cardiac amyloidosis |
| title | The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacement |
| title_full | The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacement |
| title_fullStr | The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacement |
| title_full_unstemmed | The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacement |
| title_short | The association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long-term mortality after aortic valve replacement |
| title_sort | association of prior carpal tunnel syndrome surgery with adverse cardiovascular outcomes and long term mortality after aortic valve replacement |
| topic | Carpal tunnel syndrome Aortic valve replacement Cardiac amyloidosis |
| url | http://www.sciencedirect.com/science/article/pii/S2352906721000294 |
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