Author + information
- Norman Mangner,
- Felix Woitek,
- Stephan Haussig,
- Florian Schlotter,
- Anna Lindner,
- Georg Stachel,
- Robert Hoellriegel,
- Sergey Leontyev,
- David Holzhey,
- Friedrich Mohr,
- Gerhard Schuler and
- Axel Linke
Background: Transcatheter aortic valve replacement (TAVR) has been advocated for elderly high and intermediate risk patients with aortic stenosis. Those patients are often characterized by risk factors not reflected in conventional surgical risk scores. In this context, little is known about the outcome of TAVR patients who had had a history of a tumour disease (HCD) or are suffering from an active cancer disease (ACD).
Methods: Consecutive TAVR patients treated between 2006 and 2014 were stratified according to the presence of ACD, HCD and control. All-cause-mortality at one-year was the primary end point. All end point definitions were subject to the Valve Academic Research Consortium II definitions.
Results: Overall, 1820 patients were included: 251 patients (13.8%) had HCD and 99 patients (5.4%) suffered from ACD. ACD was related to a solid organ or haematological source in 72.7% and 27.3%, respectively. LogEuroScore I was significantly lower in patients with ACD 16.0 (10.1; 25.6) vs. 14.6 (9.3; 22.5) vs. 13.7 (9.0; 23.3), p=0.027), whereas STS-Prom was comparable between groups (p=0.69). Patients with ACD were more often male compared to HCD and control (60.6% vs. 42.2% vs. 42.7%, p=0.002). All other baseline characteristics including arterial hypertension, coronary artery disease, peripheral artery disease, chronic lung disease, and chronic kidney disease were comparable between both groups. Overall rates of VARC defined periprocedural myocardial infarction, stroke, bleeding, access-site related complications and acute kidney injury were not different between groups. 30-day mortality was not different between patients with ACD compared with HCD and controls (6.1% vs. 4.4% vs. 7.6%, p=0.175). In contrast, one-year mortality was significantly higher in patients with ACD compared to those without ACD (34.3% vs. 16.0% vs. 20.2%, p<0.001). In multivariate analysis, ACD remained an independent predictor of one year mortality (HR 1.70; 95% confidence interval 1.10-2.61, p=0.017).
Conclusions: The presence of ACD in patients undergoing TAVR is associated with a significantly higher one-year mortality rate.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 4
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease Presentation Number: 1283-138
- 2017 American College of Cardiology Foundation