Muhammad Zia Khan1, Salman Zahid2, Muhammad U Khan1, Asim Kichloo3, Shakeel Jamal3, Abdul Mannan Khan Minhas4, Waqas Ullah5, Yasar Sattar1,6, Tanveer Mir7, Sudarshan Balla1, Muhammad Bilal Munir8. 1. Division of Cardiovascular Medicine, West Virginia University Heart & Vascular Institute, Morgantown, WV, USA. 2. Department of Medicine, Rochester General Hospital, Rochester, NY, USA. 3. Department of Medicine, St. Mary's of Saginaw Hospital, Saginaw, MI, USA. 4. Department of Medicine, Forrest General Hospital, Hattiesburg, MS, USA. 5. Department of Medicine, Abington Jefferson Health, PA, USA. 6. Department of Medicine, Icahn School of Medicine, Mount Sinai Elmhurst Hospital Queens, New York, NY, USA. 7. Division of Internal Medicine, Wayne State University, Detroit, MI, USA. 8. Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA.
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.
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: Young Choi; Byung-Hee Hwang; Gyu-Chul Oh; Jin Jin Kim; Eunho Choo; Min-Chul Kim; Juhan Kim; Hae Ok Jung; Ho-Joong Youn; Wook-Sung Chung; Kiyuk Chang Journal: J Clin Med Date: 2022-02-28 Impact factor: 4.241