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Int. J. Clin. Pract. · Mar 2021
Temporal Trends and Outcomes in Utilization of Transcatheter and Surgical Aortic Valve Therapies in Aortic Valve Stenosis Patients with Heart Failure.
- Yasser Al-Khadra, Yasar Sattar, Waqas Ullah, Homam Moussa Pacha, Motaz Baibars, Fahed Darmoch, Mohammed Abu-Mahfouz, Luis Afonso, Chandan Devireddy, Saif Anwaruddin, Paul Sorajja, Rasikh Ajmal, Chun Shing Kwok, Abedelrahim I Asfour, Kenton Zehr, Mamas A Mamas, and M Chadi Alraies.
- Cleveland Clinic, Medicine Institute, Cleveland, OH, USA.
- Int. J. Clin. Pract. 2021 Mar 1; 75 (3): e13711.
Introductions & AimsHeart failure (HF) is a common comorbidity in patients undergoing surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). We sought to access the temporal trends and outcomes of TAVR or SAVR in HF patients.MethodThe NIS database from 2011-2014 was queried for patients that underwent TAVR or SAVR and were subsequently diagnosed with HF. Temporal trends in the utilisation of TAVR or SAVR in HF patients were analysed.ResultsAmong 27 982 patients who were diagnosed with HF of whom 17 681 (63.2%) had heart failure with reduced ejection fraction (HFrEF) while 10 301 (36.8%) had heart failure with preserved ejection fraction (HFpEF), 9049 (32.3%) underwent TAVR and 16 933 (76.7%) underwent SAVR. Patients with HFrEF and HFpEF had higher utilisation of TAVR compared with SAVR over the course of the study period (P trend < .001). TAVR was associated with lower mortality [2.8% in 2012 and 1.8% in 2014 (P .013)] compared with SAVR. Similarly, multiple logistic regression showed a statistically significant lower in-hospital mortality in the TAVR group compared with SAVR (aOR 0.634; CI 0.504, 0.798, P < .001).ConclusionFor patients with severe aortic valve stenosis and heart failure who undergo aortic valve intervention, TAVR is associated with less odds of in-hospital mortality compared with SAVR.© 2020 John Wiley & Sons Ltd.
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