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Text
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<a href="http://doi.org/10.1002/ccd.28310" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/ccd.28310</a>
Pages
249-255
Issue
2
Volume
94
ISSN
1522-726X
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Update Year & Number
June2020SubmittedList
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Internal Medicine
Affiliated Hospital
Cleveland Clinic Akron General Hospital
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Title
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Association of peripheral artery disease with in-hospital outcomes after endovascular transcatheter aortic valve replacement.
Publisher
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Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Date
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2019
2019-08-01
Creator
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Mohananey D; Villablanca PA; Gupta T; Ranka S; Bhatia N; Adegbala O; Ando T; Wang DD; Wiley JM; Eng M; Kalra A; Ramakrishna H; Shah B; O'Neill W; Saucedo J; Bhatt DL
Description
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OBJECTIVES: The aim of this study was to determine the prevalence of peripheral artery disease (PAD) and its association with in-hospital outcomes after endovascular transcatheter aortic valve replacement (EV-TAVR). BACKGROUND: TAVR is an established treatment for patients at prohibitive, high, or intermediate surgical risk. PAD is a significant comorbidity in the determination of surgical risk. However, data on association of PAD with outcomes after EV-TAVR are limited. METHODS: Patients in the National Inpatient Sample who underwent EV-TAVR between January 1, 2012 and September 30, 2015 were evaluated. The primary outcome was in-hospital mortality. RESULTS: A total of 51,685 patients underwent EV-TAVR during the study period. Of these, 12,740 (24.6%) had a coexisting diagnosis of PAD. The adjusted odds for in-hospital mortality [OR 1.08 (95% CI 0.83-1.41)], permanent pacemaker implantation [OR 0.98 (0.85-1.14)], conversion to open aortic valve replacement [OR 1.05 (0.49-2.26)], or acute myocardial infarction [OR 1.31(0.99-1.71)] were not different in patients with versus without PAD. However, patients with PAD had greater adjusted odds of vascular complications [OR 1.80 (1.50-2.16)], major bleeding [OR 1.20 (1.09-1.34)], acute kidney injury (AKI) [OR 1.19 (1.05-1.36)], cardiac complications [aOR 1.21 (1.01-1.44)], and stroke [OR 1.39(1.10-1.75)] compared with patients without PAD. Length of stay (LOS) was significantly longer for patients with PAD [7.23 (0.14) days vs. 7.11 (0.1) days, p < 0.001]. CONCLUSION: Of patients undergoing EV-TAVR, ~25% have coexisting PAD. PAD was not associated with increased risk of in-hospital mortality but was associated with higher risk of vascular complications, major bleeding, AKI, stroke, cardiac complications, and longer LOS.
Identifier
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<a href="http://doi.org/10.1002/ccd.28310" target="_blank" rel="noreferrer noopener">10.1002/ccd.28310</a>
PMID: 31025488
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© 2019 Wiley Periodicals, Inc.
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journalArticle
2019
Adegbala O
Ando T
Bhatia N
Bhatt DL
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Cleveland Clinic Akron General Hospital
Department of Internal Medicine
Eng M
Gupta T
journalArticle
June2020SubmittedList
Kalra A
Mohananey D
NEOMED College of Medicine
O'Neill W
Ramakrishna H
Ranka S
Saucedo J
Shah B
Villablanca PA
Wang DD
Wiley JM