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Impact of baseline cigarette smoking status on clinical outcome after transcatheter aortic valve replacement
Author(s) -
Abawi Masieh,
Gils Lennart,
Agostoni Pierfrancesco,
Mieghem Nicolas M.,
Kooistra Nynke H. M.,
Dongen Charlotte S.,
Jaarsveld Romy C.,
Jaegere Peter P. T.,
Doevendans Pieter A. F. M.,
Stella Pieter R.
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28175
Subject(s) - medicine , interquartile range , hazard ratio , valve replacement , confidence interval , aortic valve stenosis , odds ratio , stenosis , cardiology , surgery
Objectives To explore the prevalence of smoking, and its association with clinical and mortality outcome among patients undergoing transcatheter aortic valve replacement (TAVR). Background Less data exist regarding the effect of baseline smoking status on clinical and mortality outcome among patients undergoing TAVR. Methods Consecutive patients who underwent TAVR at two high volume Dutch centers were included. Smoking status was prospectively questioned by a structured interview at admission. Primary endpoint was 1‐year all‐cause mortality after TAVR. Results A total of 913 consecutive patients (80.1 ± 7.6 years; logistic EuroSCORE: 16.5 ± 9.9%) who underwent TAVR for severe aortic valve stenosis were included. There were 47% ( n = 432) males, and 57% ( n = 522) never‐smokers, and 35% ( n = 317) prior‐smokers, and 8% ( n = 74) current‐smokers. Smokers (i.e., prior‐smokers or current‐smokers) were younger compared to never‐smokers (78.9 ± 7.9 and 76.4 ± 8.0 vs. 81.3 ± 7.1, P < 0.000, respectively). Median follow‐up time was 365 (interquartile range [IQR]: 280–365) days. Overall, prior‐smoking was not associated with all‐cause mortality at 1‐year following TAVR (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.55–1.23). After stratification according to sex, male prior‐smokers showed better 1‐year survival after TAVR than male never‐smokers (12% vs. 20%; P = 0.018, respectively, HR 0.52, 95% CI 0.29–0.89), while this reversed effect was not observed among female prior‐smokers versus female never‐smokers after TAVR (HR 1.70, 95% CI 0.95–3.05). Conclusions Overall, baseline prior‐smokers had similar 1‐year mortality outcome after TAVR compared with baseline never‐smokers. However, there was a reversed association between baseline prior‐smoking status and 1‐year mortality after TAVR among males, which could partially be explained due to the favorable baseline characteristics.