Author + information
- Samantha Novotny,
- Jie Yang,
- Donglei Yin,
- Allen Jeremias,
- Luis Gruberg,
- Javed Butler and
- Puja Parikh
Background: Balloon aortic valvuloplasty (BAV) is often utilized as a bridge prior to surgical or transcatheter aortic valve replacement. Chronic kidney disease (CKD) is commonly present in patients with aortic stenosis, however, its association with clinical outcomes following BAV has not been well studied. Accordingly, we sought to assess the impact of CKD on mortality in adults undergoing BAV.
Methods: The Healthcare Utilization Project's Nationwide Inpatient Sample was screened for hospitalizations involving adults undergoing BAV from 2006 to 2012. Demographic data and clinical history were recorded in adults with and without a history of CKD. The primary outcome of interest was in-hospital mortality.
Results: Among an estimated national cohort of 10,844 adults undergoing BAV, 3842 (35.4%) adults had CKD while 7003 (64.6%) did not. BAV patients with CKD were older (81.5 vs 80.5 years, p=0.0187) and more often male (59.1% vs 46.2%, p<0.0001). They had significantly higher rates of coronary artery disease (74.8% vs 67.3%, p=0.0004), congestive heart failure (78.6% vs 62.5%, p<0.0001), diabetes mellitus (40.2% vs 29.6%, p<0.0001), hypertension (82.2% vs 61.2%, p<0.0001), peripheral artery disease (21.5% vs 15.5%, p=0.0004), obesity (10.1% vs 7.5%, p=0.0224), obstructive sleep apnea (7.4% vs 5.0%, p=0.0300), and atrial fibrillation (42.9% vs 36.5%, p=0.0010). Adults with CKD undergoing BAV had significantly higher rates of in-hospital mortality (10.2% vs 6.3%, p=0.0005). In multivariable analysis, CKD was independently associated with a nearly 2-fold higher odds of in-hospital mortality (OR 1.98, 95% CI 1.45-2.70, p<0.0001). Other predictors of mortality included presence of atrial fibrillation (OR 1.37, 95% CI 1.02-1.85, p=0.0369) and absence of prior myocardial infarction, hypertension, peripheral arterial disease, and smoking.
Conclusions: CKD was independently associated with a nearly 2-fold higher odds of in-hospital mortality in adults undergoing BAV. Further studies are warranted to determine whether pharmacological and/or technical interventions can be performed to improve outcomes in this high-risk population.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-175
- 2017 American College of Cardiology Foundation