Author + information
- Alice Wang,
- Hanghang Wang,
- Ehsan Benrashid,
- David Ranney,
- Babatunde Yerokun,
- Matthew W. Sherwood,
- Jeffrey Gaca,
- Todd Kiefer,
- Andrew Wang,
- John Harrison and
- G. Chad Hughes
Background: Mortality after TAVR is influenced by co-morbidities. Registries lack data granularity and clinical trials may not be reflective of “real world” practice. We investigated predictors of mortality after TAVR for all patients treated at a single institution since 2011.
Methods: After IRB approval, retrospective analysis was performed on 526 patients. A Cox proportional hazards model examined predictors of survival; variables were selected using lasso regression with the tuning parameter chosen by K-fold cross-validation. Final variables in the survival analysis were chosen by stepwise forward selection using the AIC criteria.
Results: Survival analysis included 97 mortality events. Mean age was 77±14 years, 33% of patients had peripheral vascular disease (PVD), 18% had history of myocardial infarction (MI), and mean STS score was 7.5±4%. Mean ejection fraction (EF) was 49±10%, diffusion capacity for carbon monoxide (DLCO) 63±20%, and pulmonary artery pressure (PAP) 30±11 mmHg. Mean time to death was 1.3±1.3 years. Variables related to mortality were older age, PVD, lower EF, prior MI and lower DLCO (Figure). PAP was not related to mortality. Among patients without a diagnosis of obstructive lung disease (n=357), 164 (46%) had an abnormal DLCO <75%.
Conclusions: In addition to variables reported in registry data and clinical trials, we found lower DLCO as a novel predictor of mortality after TAVR. Even in patients without known lung disease, pulmonary function tests should be considered.
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: 1283-145
- 2017 American College of Cardiology Foundation