Outcomes of transcatheter aortic valve replacement in patients with and without atrial fibrillation: Insight from national inpatient sample.

Abstract

BACKGROUND:

Atrial fibrillation (AF) is one of the most frequent rhythm disturbance encountered in the population in general. Our study aims to evaluate the in-hospital outcomes of TAVR with AF.

METHODS:

We used National Inpatient Sample database from 2011 to 2018. Baseline characteristics and in-hospital outcomes were evaluated in TAVR based on AF status or not in both unmatched and propensity-matched cohorts.

RESULTS:

A total of 215,938 patients underwent TAVR during our study period and out of these AF was encountered in 89,587 (41.5%) patients. AF patients undergoing TAVR had a higher mean age and had an increased burden of key co-morbidities in the unmatched cohort. With propensity matched 1:1 analysis, AF had higher mortality as compared to no-AF group (2.4% vs. 2.1%, p < 0.01). The rate of cardiogenic shock (2.9% vs 2.1%), respiratory complications (9.9% vs 8.2%), acute kidney injury (15.6% vs 12.0%), vascular complications (5.0% vs 4.7%), and blood transfusion (10.4% vs 8.6%) was higher in TAVR patients with AF. A lower proportion of patients had routine discharge to home for TAVR with AF (80.8% vs 74.4%). Cost of hospitalization (23,0171[SD, 20,5242] vs 210,608[28,4203]) and length of stay (5.7[SD, 11.8] vs 4.29[7.2] days) were considerably higher in patients undergoing TAVR with AF.

CONCLUSION:

Patients undergoing TAVR with concomitant AF tended to have increased mortality, complications, length, and cost of stay compared to non-AF patients.

• Authors: Muhammad Zia Khan, Salman Zahid, Muhammad U Khan, Asim Kichloo, Shakeel Jamal, Abdul Mannan Khan Minhas, Waqas Ullah, Yasar Sattar, Tanveer Mir, Sudarshan Balla, Muhammad Bilal Munir
• Journal: Expert review of cardiovascular therapy (Expert Rev Cardiovasc Ther) Vol. 19 Issue 10 Pg. 939-946 (Oct 2021) ISSN: 1744-8344 [Electronic] England
• PMID: 34605353 (Publication Type: Journal Article)

Topics

• Aortic Valve (surgery)
• Aortic Valve Stenosis (surgery)
• Atrial Fibrillation (epidemiology, therapy)
• Hospital Mortality
• Humans
• Inpatients
• Length of Stay
• Postoperative Complications (epidemiology)
• Retrospective Studies
• Risk Factors
• Time Factors
• Transcatheter Aortic Valve Replacement (adverse effects)
• Treatment Outcome
• United States (epidemiology)