TY - JOUR
T1 - Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppressiontreated patients
T2 - a propensity-matched multicentre retrospective registry-based analysis
AU - Walczewski, Michał
AU - Gąsecka, Aleksandra
AU - Witkowski, Adam
AU - Dabrowski, Maciej
AU - Huczek, Zenon
AU - Wilimski, Radosław
AU - Ochała, Andrzej
AU - Parma, Radosław
AU - Rymuza, Bartosz
AU - Grygier, Marek
AU - Jemielity, Marek
AU - Olasińska-Wiśniewska, Anna
AU - Jagielak, Dariusz
AU - Targoński, Radosław
AU - Pastuszak, Krzysztof
AU - Grešner, Peter
AU - Grabowski, Marcin
AU - Kochman, Janusz
N1 - Funding Information: We would like to thank Peter Grešner and Krzysztof Pastuszak from the Centre of Biostatistics and Bioinfor-matics Analyses, Medical University of Gdansk, Poland for performing biostatistical analyses and providing biostatistics consultations. The centre is working as a part of the Excellence Initiative “Research University” grant no. MNISW 07/IDUB/2019/94. Publisher Copyright: © 2023 Termedia Publishing House Ltd.. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Introduction: Data regarding patients with a previous medical record of immunosuppression treatment who have undergone transcatheter aortic valve implantation (TAVI) are limited and extremely inconclusive. Available studies are mostly short term observations; thus there is a lack of evidence on efficacy and safety of TAVI in this specific group of patients. Aim: To compare the in-hospital and long-term outcomes between patients with or without a medical history of immunosuppressive treatment undergoing TAVI for aortic valve stenosis (AS). Material and methods: We conducted a retrospective registry-based analysis including patients undergoing TAVI for AS at 5 centres between January 2009 and August 2017. The primary endpoint was long-term all-cause mortality. Secondary endpoints comprised major vascular complications, life-threatening or disabling bleeding, stroke and new pacemaker implantation. Results: Of 1451 consecutive patients who underwent TAVI, two propensity-matched groups including 25 patients with a history of immunosuppression and 75 patients without it were analysed. No differences between groups in all-cause mortality were found in a median follow-up time of 2.7 years following TAVI (p = 0.465; HR = 0.73; 95% CI: 0.30-1.77). The rate of major vascular complications (4.0% vs. 5.3%) was similar in the two groups (p = 1.000). There were no statistically significant differences in the composite endpoint combining life-threatening or disabling bleeding, major vascular complications, stroke and new pacemaker implantation (40.0% vs. 20.0%, p = 0.218). Conclusions: Patients who had undergone TAVI for AS had similar long-term mortality regardless of whether they had a previous medical record of immunosuppression. Procedural complication rates were comparable between the groups.
AB - Introduction: Data regarding patients with a previous medical record of immunosuppression treatment who have undergone transcatheter aortic valve implantation (TAVI) are limited and extremely inconclusive. Available studies are mostly short term observations; thus there is a lack of evidence on efficacy and safety of TAVI in this specific group of patients. Aim: To compare the in-hospital and long-term outcomes between patients with or without a medical history of immunosuppressive treatment undergoing TAVI for aortic valve stenosis (AS). Material and methods: We conducted a retrospective registry-based analysis including patients undergoing TAVI for AS at 5 centres between January 2009 and August 2017. The primary endpoint was long-term all-cause mortality. Secondary endpoints comprised major vascular complications, life-threatening or disabling bleeding, stroke and new pacemaker implantation. Results: Of 1451 consecutive patients who underwent TAVI, two propensity-matched groups including 25 patients with a history of immunosuppression and 75 patients without it were analysed. No differences between groups in all-cause mortality were found in a median follow-up time of 2.7 years following TAVI (p = 0.465; HR = 0.73; 95% CI: 0.30-1.77). The rate of major vascular complications (4.0% vs. 5.3%) was similar in the two groups (p = 1.000). There were no statistically significant differences in the composite endpoint combining life-threatening or disabling bleeding, major vascular complications, stroke and new pacemaker implantation (40.0% vs. 20.0%, p = 0.218). Conclusions: Patients who had undergone TAVI for AS had similar long-term mortality regardless of whether they had a previous medical record of immunosuppression. Procedural complication rates were comparable between the groups.
KW - aortic stenosis
KW - immunosuppression
KW - mortality
KW - outcomes
KW - transcatheter aortic valve implantation
UR - http://www.scopus.com/inward/record.url?scp=85174406014&partnerID=8YFLogxK
U2 - https://doi.org/10.5114/aic.2023.131478
DO - https://doi.org/10.5114/aic.2023.131478
M3 - Article
C2 - 37854972
SN - 1734-9338
VL - 19
SP - 251
EP - 256
JO - Postepy w Kardiologii Interwencyjnej
JF - Postepy w Kardiologii Interwencyjnej
IS - 3
ER -