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Association of peripheral artery disease with in‐hospital outcomes after endovascular transcatheter aortic valve replacement
Author(s) -
Mohananey Divyanshu,
Villablanca Pedro,
Gupta Tanush,
Ranka Sagar,
Bhatia Nirmanmoh,
Adegbala Oluwole,
Ando Tomo,
Wang Dee Dee,
Wiley Jose M.,
Eng Marvin,
Kalra Ankur,
Ramakrishna Harish,
Shah Binita,
O'Neill William,
Saucedo Jorge,
Bhatt Deepak L.
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.28310
Subject(s) - medicine , arterial disease , valve replacement , aortic valve replacement , cardiology , peripheral , vascular disease , surgery , stenosis
Objectives The aim of this study was to determine the prevalence of peripheral artery disease (PAD) and its association with in‐hospital outcomes after endovascular transcatheter aortic valve replacement (EV‐TAVR). Background TAVR is an established treatment for patients at prohibitive, high, or intermediate surgical risk. PAD is a significant comorbidity in the determination of surgical risk. However, data on association of PAD with outcomes after EV‐TAVR are limited. Methods Patients in the National Inpatient Sample who underwent EV‐TAVR between January 1, 2012 and September 30, 2015 were evaluated. The primary outcome was in‐hospital mortality. Results A total of 51,685 patients underwent EV‐TAVR during the study period. Of these, 12,740 (24.6%) had a coexisting diagnosis of PAD. The adjusted odds for in‐hospital mortality [OR 1.08 (95% CI 0.83–1.41)], permanent pacemaker implantation [OR 0.98 (0.85–1.14)], conversion to open aortic valve replacement [OR 1.05 (0.49–2.26)], or acute myocardial infarction [OR 1.31(0.99–1.71)] were not different in patients with versus without PAD. However, patients with PAD had greater adjusted odds of vascular complications [OR 1.80 (1.50–2.16)], major bleeding [OR 1.20 (1.09–1.34)], acute kidney injury (AKI) [OR 1.19 (1.05–1.36)], cardiac complications [aOR 1.21 (1.01–1.44)], and stroke [OR 1.39(1.10–1.75)] compared with patients without PAD. Length of stay (LOS) was significantly longer for patients with PAD [7.23 (0.14) days vs. 7.11 (0.1) days, p < 0.001]. Conclusion Of patients undergoing EV‐TAVR, ~25% have coexisting PAD. PAD was not associated with increased risk of in‐hospital mortality but was associated with higher risk of vascular complications, major bleeding, AKI, stroke, cardiac complications, and longer LOS.