Cardiovascular Outcomes of Transcatheter Aortic Valve Implantation in Patients With Chronic Kidney Disease in Octogenarian Population
Department
Internal Medicine
Document Type
Article
Publication Title
The American Journal of Cardiology
Abstract
Limited data are available regarding in-hospital outcomes of transcatheter aortic valve implantation (TAVI) in the octogenarian population with chronic kidney disease (CKD). We sought to study the cardiovascular outcomes of TAVI in CKD hospitalization with different stages at the national cohort registry. We used the National Inpatient Sample database to compare TAVI CKD low-grade (LG) (stage I to IIIa, b) versus TAVI CKD high-grade (HG) (stage IV to V) in octogenarians. Outcomes such as inpatient mortality, cardiogenic shock, new permanent pacemaker implantation, acute kidney injury), sudden cardiac arrest, mechanical circulatory support, major bleeding, transfusion, and resource utilization were compared between the 2 cohorts. A total of 74,766 octogenarian patients (TAVI CKD-HG n = 12,220; TAVI CKD-LG n = 62,545) were included in our study. On matched analysis, TAVI CKD-HG had higher odds of in-hospital mortality (adjusted odds ratio [aOR] 2.18, 95% confidence interval [CI] 1.0-2.5, p < 0.0001), cardiogenic shock (aOR 1.22, 95% CI 1.07 to 1.39, p = 0.0019), permanent pacemaker implantation (aOR 1.14, 95% CI 1.06 to 1.23, p = 0.0006), acute kidney injury (aOR 1.19, 95% CI 1.13 to 1.27, p < 0.0001), sudden cardiac arrest (aOR 1.32, 95% CI 1.09 to 1.61, p = 0.004), major bleeding (aOR 1.1, 95% CI 1.006 to 1.22, p < 0.0368) and higher rates of blood transfusion (aOR 1.62, 95% CI 1.5 to 1.75, p < 0.0001) when compared with the TAVI CKD-LG cohort. However, there was no statistically significant difference in the odds of cerebrovascular accident and mechanical circulatory support use between the 2 groups.
First Page
163
Last Page
171
DOI
10.1016/j.amjcard.2023.07.083
Volume
211
Publication Date
1-15-2024
Medical Subject Headings
Aged, 80 and over; Humans; Transcatheter Aortic Valve Replacement; Octogenarians; Aortic Valve Stenosis (complications, surgery); Shock, Cardiogenic (epidemiology); Treatment Outcome; Renal Insufficiency, Chronic (complications, epidemiology); Aortic Valve (surgery); Acute Kidney Injury (epidemiology); Death, Sudden, Cardiac; Hemorrhage; Risk Factors
PubMed ID
38043436
Recommended Citation
Song, D., Sattar, Y., Faisaluddin, M., Talib, U., Patel, N., Shahid, I., Taha, A., Raheela, F., Sengodon, P., Riasat, M., Shah, V., Gonuguntla, K., Alam, M., Elgendy, I., Daggubati, R., & Alraies, M. C. (2024). Cardiovascular Outcomes of Transcatheter Aortic Valve Implantation in Patients With Chronic Kidney Disease in Octogenarian Population. The American Journal of Cardiology, 211, 163-171. https://doi.org/10.1016/j.amjcard.2023.07.083