Author + information
- Lee Joseph,
- Mohammad Bashir,
- Qun Xiang,
- Babatunde Yerokun,
- Roland Matsouaka,
- Sreekanth Vemulapalli,
- Samir Kapadia and
- Firas Zahr
Background: The prevalence of mitral stenosis (MS) and its impact on in-hospital and 1 year clinical outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) are unknown.
Methods: We included 44,755 adult patients who underwent TAVR (11/1/2011 – 9/30/2015) in the STS/ACC TVT Registry and those with available Centers for Medicare & Medicaid Services linkage for 1 year outcomes (N= 31,511). Primary outcome was the composite of death, stroke, heart failure, and mitral valve re-intervention at 1 year. We used chi-square test for in-hospital mortality, Cox proportional regression model for 1-year composite and mortality, and Fine and Gray's model for 1 year non-fatal outcomes.
Results: The cohort had 52% males, mean age 82 years and 11.6% patients had MS, 2.7% being severe MS (defined as mitral valve area ≤1.5 cm2). Severe MS was associated with higher in-hospital mortality rates (5.6% vs. 3.9% for non-severe MS and 4.1% for no MS, P=0.023). In contrast to those without MS, adjusted hazard ratios(HR) of the primary outcome, mortality (1 year) and heart failure (1 year) were significantly higher in severe MS group (HR (95% CI), 1.22(1.08-1.38), 1.18 (1.0-1.39) & 1.28 (1.06-1.53) respectively, P<0.05 for all). Figure 1 shows Kaplan Meier plots for 1-year composite and mortality outcomes.
Conclusions: Though MS is infrequent, severe MS is associated with adverse in-hospital and 1 year clinical outcomes following TAVR. This study highlights the importance of considering MS during TAVR evaluation.
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: 1195-183
- 2017 American College of Cardiology Foundation