Urgent versus Non-Urgent Transcatheter Aortic Valve Implantation Outcomes
© 2023 S. Karger AG, Basel..
INTRODUCTION: There are limited data about the outcomes of nonelective transcatheter aortic valve implantation (TAVI). Some studies suggest that these patients (pts) have worst results. Our purpose was to compare outcomes in pts submitted to urgent versus elective TAVI.
METHODS: Retrospective analysis of 298 consecutive pts submitted to TAVI between 2018 and 2021 in a single tertiary center. Baseline characteristics and outcomes were collected and compared between elective and nonelective TAVI.
RESULTS: Pts submitted to urgent TAVI (79 pts) had worse baseline characteristics, with higher EuroScore risk (9.26 vs. 5.17%, p < 0.0001), STS score (7.09 vs. 4.4%, p < 0.0001), and NT pro-natriuretic peptide B (10,168 vs. 3,241 pg/mL, p = 0.001), lower left ventricle ejection fraction (45 vs. 52%, p = 0.003), more diabetes (46.8 vs. 32.4%, p = 0.0.22), peripheral artery disease (21.5 vs. 6.8%, p < 0.0001), and poor vascular accesses (18.4 vs. 7.4%, p = 0.007). Urgent TAVI was associated with higher mortality (25.3 vs. 15.1%, p = 0.043), 30-day cardiovascular mortality (17.5 vs. 4%, p = 0.001), life-threatening bleeding (11.5 vs. 4.1%, p = 0.018), vascular complications (11.5 vs. 4.6%, p = 0.031), and longer hospital stay (28 vs. 12 days, p < 0.0001), but not with intensive care unit or post-TAVI hospital stay (5 vs. 4 days, p = 0.197 and 11 vs. 10 days, p = 0.572). When adjusted to differences in baseline characteristics, urgent TAVI was only associated with longer hospital stay (p < 0.0001).
CONCLUSION: Pts submitted to urgent TAVI have worse short-term outcomes, but this seems to be attributable to the worse baseline characteristics instead of the urgent nature of the procedure.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:148 |
|---|---|
| Enthalten in: |
Cardiology - 148(2023), 5 vom: 01., Seite 469-477 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Castelo, Alexandra [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Aortic stenosis |
|---|
| Anmerkungen: |
Date Completed 04.10.2023 Date Revised 05.10.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1159/000531815 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM359302602 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM359302602 | ||
| 003 | DE-627 | ||
| 005 | 20231226080601.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1159/000531815 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1197.xml |
| 035 | |a (DE-627)NLM359302602 | ||
| 035 | |a (NLM)37429257 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Castelo, Alexandra |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Urgent versus Non-Urgent Transcatheter Aortic Valve Implantation Outcomes |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.10.2023 | ||
| 500 | |a Date Revised 05.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 S. Karger AG, Basel. | ||
| 520 | |a INTRODUCTION: There are limited data about the outcomes of nonelective transcatheter aortic valve implantation (TAVI). Some studies suggest that these patients (pts) have worst results. Our purpose was to compare outcomes in pts submitted to urgent versus elective TAVI | ||
| 520 | |a METHODS: Retrospective analysis of 298 consecutive pts submitted to TAVI between 2018 and 2021 in a single tertiary center. Baseline characteristics and outcomes were collected and compared between elective and nonelective TAVI | ||
| 520 | |a RESULTS: Pts submitted to urgent TAVI (79 pts) had worse baseline characteristics, with higher EuroScore risk (9.26 vs. 5.17%, p < 0.0001), STS score (7.09 vs. 4.4%, p < 0.0001), and NT pro-natriuretic peptide B (10,168 vs. 3,241 pg/mL, p = 0.001), lower left ventricle ejection fraction (45 vs. 52%, p = 0.003), more diabetes (46.8 vs. 32.4%, p = 0.0.22), peripheral artery disease (21.5 vs. 6.8%, p < 0.0001), and poor vascular accesses (18.4 vs. 7.4%, p = 0.007). Urgent TAVI was associated with higher mortality (25.3 vs. 15.1%, p = 0.043), 30-day cardiovascular mortality (17.5 vs. 4%, p = 0.001), life-threatening bleeding (11.5 vs. 4.1%, p = 0.018), vascular complications (11.5 vs. 4.6%, p = 0.031), and longer hospital stay (28 vs. 12 days, p < 0.0001), but not with intensive care unit or post-TAVI hospital stay (5 vs. 4 days, p = 0.197 and 11 vs. 10 days, p = 0.572). When adjusted to differences in baseline characteristics, urgent TAVI was only associated with longer hospital stay (p < 0.0001) | ||
| 520 | |a CONCLUSION: Pts submitted to urgent TAVI have worse short-term outcomes, but this seems to be attributable to the worse baseline characteristics instead of the urgent nature of the procedure | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aortic stenosis | |
| 650 | 4 | |a Percutaneous interventions | |
| 650 | 4 | |a Transcatheter aortic valve implantation | |
| 650 | 4 | |a Urgent | |
| 700 | 1 | |a Teixeira, Bárbara |e verfasserin |4 aut | |
| 700 | 1 | |a Grazina, André |e verfasserin |4 aut | |
| 700 | 1 | |a Mendonça, Tiago |e verfasserin |4 aut | |
| 700 | 1 | |a Rodrigues, Inês |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia Brás, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, Vera Vaz |e verfasserin |4 aut | |
| 700 | 1 | |a Ramos, Rúben |e verfasserin |4 aut | |
| 700 | 1 | |a Fiarresga, António |e verfasserin |4 aut | |
| 700 | 1 | |a Cruz Ferreira, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Cacela, Duarte |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cardiology |d 1970 |g 148(2023), 5 vom: 01., Seite 469-477 |w (DE-627)NLM000038881 |x 1421-9751 |7 nnns |
| 773 | 1 | 8 | |g volume:148 |g year:2023 |g number:5 |g day:01 |g pages:469-477 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1159/000531815 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 148 |j 2023 |e 5 |b 01 |h 469-477 | ||