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Prognostic impact and periprocedural complications of chronic steroid therapy in patients following transcatheter aortic valve replacement: Propensity‐matched analysis from the Japanese OCEAN registry
Author(s) -
Koyama Yutaka,
Yamamoto Masanori,
Kagase Ai,
Tsujimoto Satoshi,
Kano Seiji,
Shimura Tetsuro,
Hosoba Soh,
Watanabe Yusuke,
Tada Norio,
Naganuma Toru,
Araki Motoharu,
Yamanaka Futoshi,
Mizutani Kazuki,
Tabata Minoru,
Ueno Hiroshi,
Takagi Kensuke,
Higashimori Akihiro,
Shirai Shinichi,
Hayashida Kentaro
Publication year - 2020
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.28332
Subject(s) - medicine , incidence (geometry) , valve replacement , propensity score matching , cardiology , stenosis , steroid , surgery , mortality rate , aortic valve replacement , physics , hormone , optics
Objective This study aimed to assess the effect of chronic steroid use on periprocedural complications and clinical outcomes after transcatheter aortic valve replacement (TAVR). Background Chronic steroid use increases the risk of periprocedural complications and mortality during surgery. Methods We investigated 1,313 consecutive patients with aortic stenosis who underwent transfemoral (TF)‐TAVR using data from a Japanese multicenter registry. The baseline characteristics, periprocedural complications including vascular complications (VCs), access route related VCs, and clinical outcomes were compared between patients in the steroid group and nonsteroid group. Results Major VCs and access route VCs occurred more in the steroid group than in the nonsteroid group (13.4 vs. 5.8%, p = .019; 20.9% vs. 9.8%, p = .004). Especially in the surgical cut‐down group, the rate of access route VCs was differed between the two groups (28.0% vs. 7.5%, p = .003). The 30‐day mortality rates were similar between the two groups (0% vs. 1.4%, p = .39). In the propensity score‐matched model, the higher incidence of major VCs in the steroid group was maintained, although early mortality was similar in the two groups. Conclusions Although chronic steroid therapy is not associated with increased early mortality, chronic steroid use may affect periprocedural VCs and access route VCs mainly due to surgical cut‐down in patients following TF‐TAVR.