Clinical Outcomes in Atrial Fibrillation Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices
Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in aortic stenosis patients. However, the factors associated with poorer outcomes among AF patients in contemporary TAVR practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, rem...
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| creator | Mengi, Siddhartha Cepas-Guillén, Pedro L. Ternacle, Julien Urena, Marina Alperi, Alberto Cheema, Asim N. Veiga-Fernandez, Gabriela Nombela-Franco, Luis Vilata, Victoria Esposito, Giovanni Campelo-Parada, Francisco Indolfi, Ciro del Trigo, Maria Munoz-Garcia, Antonio Maneiro, Nicolas Asmarats, Lluís Reguiero, Ander Del Val, David Serra, Vicenç Auffret, Vincent Leroux, Lionel Modine, Thomas Mesnier, Jules Suc, Gaspard Avanzas, Pablo Rezaei, Effar Fradejas-Sastre, Victor Tirado-Conte, Gabriela Fernández-Nofrerias, Eduard Angellotti, Domenico Guitteny, Thibaut Sorrentino, Sabato Oteo, Juan Francisco Díez-Delhoyo, Felipe Gutiérrez-Alonso, Lola Vidal, Pablo Alfonso, Fernando Monastyrski, Andrea Nolf, Maxime Avvedimento, Marisa Rodés-Cabau, Josep |
| description | Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in aortic stenosis patients. However, the factors associated with poorer outcomes among AF patients in contemporary TAVR practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, remain largely unknown.
Multicenter study including consecutive patients with a history of AF, evaluating the clinical outcomes and predictors of mortality, and HF-related hospitalization, who underwent TAVR with newer-generation devices using balloon or self-expandable valves.
A total of 3,476 patients were included. After a median follow-up of 2 (1-4) years, 36.4% had died, with 51.5% of deaths being cardiovascular-related, including 15.6% from HF. HF-related hospitalizations post-TAVR accounted for 34.8% of all hospitalizations and exhibited a significantly higher mortality risk (HR:1.54;95%CI:1.32-1.81;P |
| doi_str_mv | 10.1016/j.cjca.2024.12.007 |
| format | Article |
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Multicenter study including consecutive patients with a history of AF, evaluating the clinical outcomes and predictors of mortality, and HF-related hospitalization, who underwent TAVR with newer-generation devices using balloon or self-expandable valves.
A total of 3,476 patients were included. After a median follow-up of 2 (1-4) years, 36.4% had died, with 51.5% of deaths being cardiovascular-related, including 15.6% from HF. HF-related hospitalizations post-TAVR accounted for 34.8% of all hospitalizations and exhibited a significantly higher mortality risk (HR:1.54;95%CI:1.32-1.81;P<0.001). Permanent AF emerged as an independent predictor of all-cause death or HF-related hospitalizations (HR:1.25; 95%CI:1.10-1.40;P<0.001), as did other baseline characteristics, including chronic kidney disease (HR:1.23;95%CI:1.09-1.38;P=0.001), anemia (HR:1.21; 95%CI:1.07-1.36;P=0.002), and New York Heart Association class III or IV (HR:1.13; 95%CI:1.01-1.27;P=0.045). Additionally, early post-procedural complications, including stroke and bleeding also significantly increased the risk of mortality and HF-related hospitalizations (HR:5.52;95%CI:3.12-9.79;P<0.001 & HR:1.17;95%CI:1.03-1.33;P=0.014, respectively).
AF patients exhibited a high risk of HF-related hospitalizations in a contemporary TAVR cohort. Several baseline co-morbidities and periprocedural complications, along with permanent (vs. paroxysmal) AF were associated with poorer outcomes. These findings confirm the negative impact of AF despite the continued improvements in TAVR technology and underscore the importance of early intervention and optimization of HF management to improve outcomes in this high-risk population.
[Display omitted]</description><identifier>ISSN: 0828-282X</identifier><identifier>ISSN: 1916-7075</identifier><identifier>EISSN: 1916-7075</identifier><identifier>DOI: 10.1016/j.cjca.2024.12.007</identifier><identifier>PMID: 39667494</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Cardiology and cardiovascular system ; Human health and pathology ; Life Sciences</subject><ispartof>Canadian journal of cardiology, 2024-12</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1864-cc045ed5d5422ab068cea4a6be5707915a527b7057d765df76072118ff1f67d13</cites><orcidid>0000-0001-6825-8794 ; 0000-0002-3174-8957 ; 0000-0001-8248-5619 ; 0000-0003-2219-921X ; 0000-0002-5512-3820 ; 0000-0002-8316-7134 ; 0000-0003-1821-0658 ; 0000-0003-4169-3766 ; 0000-0003-0535-2120 ; 0000-0001-8814-7039 ; 0000-0002-4958-6108 ; 0000-0002-7941-0779 ; 0000-0002-7480-2511 ; 0000-0002-3357-5834 ; 0000-0002-7093-3936 ; 0000-0002-2641-4135 ; 0000-0003-0565-7127 ; 0000-0001-7784-5501 ; 0000-0003-0225-9975 ; 0000-0002-8443-7888 ; 0000-0002-4150-290X ; 0000-0003-1241-6487 ; 0000-0003-3376-8473 ; 0000-0002-4434-0264 ; 0000-0002-0747-2751 ; 0000-0002-9629-5864 ; 0000-0002-5435-1100 ; 0000-0001-8276-7325 ; 0000-0003-2269-8449 ; 0000-0002-2131-6763 ; 0000-0003-3438-8907 ; 0000-0003-0957-8434 ; 0000-0001-7960-5253 ; 0000-0002-9481-646X ; 0000-0002-9939-8949</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0828282X24012479$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39667494$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-04891625$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Mengi, Siddhartha</creatorcontrib><creatorcontrib>Cepas-Guillén, Pedro L.</creatorcontrib><creatorcontrib>Ternacle, Julien</creatorcontrib><creatorcontrib>Urena, Marina</creatorcontrib><creatorcontrib>Alperi, Alberto</creatorcontrib><creatorcontrib>Cheema, Asim N.</creatorcontrib><creatorcontrib>Veiga-Fernandez, Gabriela</creatorcontrib><creatorcontrib>Nombela-Franco, Luis</creatorcontrib><creatorcontrib>Vilata, Victoria</creatorcontrib><creatorcontrib>Esposito, Giovanni</creatorcontrib><creatorcontrib>Campelo-Parada, Francisco</creatorcontrib><creatorcontrib>Indolfi, Ciro</creatorcontrib><creatorcontrib>del Trigo, Maria</creatorcontrib><creatorcontrib>Munoz-Garcia, Antonio</creatorcontrib><creatorcontrib>Maneiro, Nicolas</creatorcontrib><creatorcontrib>Asmarats, Lluís</creatorcontrib><creatorcontrib>Reguiero, Ander</creatorcontrib><creatorcontrib>Del Val, David</creatorcontrib><creatorcontrib>Serra, Vicenç</creatorcontrib><creatorcontrib>Auffret, Vincent</creatorcontrib><creatorcontrib>Leroux, Lionel</creatorcontrib><creatorcontrib>Modine, Thomas</creatorcontrib><creatorcontrib>Mesnier, Jules</creatorcontrib><creatorcontrib>Suc, Gaspard</creatorcontrib><creatorcontrib>Avanzas, Pablo</creatorcontrib><creatorcontrib>Rezaei, Effar</creatorcontrib><creatorcontrib>Fradejas-Sastre, Victor</creatorcontrib><creatorcontrib>Tirado-Conte, Gabriela</creatorcontrib><creatorcontrib>Fernández-Nofrerias, Eduard</creatorcontrib><creatorcontrib>Angellotti, Domenico</creatorcontrib><creatorcontrib>Guitteny, Thibaut</creatorcontrib><creatorcontrib>Sorrentino, Sabato</creatorcontrib><creatorcontrib>Oteo, Juan Francisco</creatorcontrib><creatorcontrib>Díez-Delhoyo, Felipe</creatorcontrib><creatorcontrib>Gutiérrez-Alonso, Lola</creatorcontrib><creatorcontrib>Vidal, Pablo</creatorcontrib><creatorcontrib>Alfonso, Fernando</creatorcontrib><creatorcontrib>Monastyrski, Andrea</creatorcontrib><creatorcontrib>Nolf, Maxime</creatorcontrib><creatorcontrib>Avvedimento, Marisa</creatorcontrib><creatorcontrib>Rodés-Cabau, Josep</creatorcontrib><title>Clinical Outcomes in Atrial Fibrillation Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices</title><title>Canadian journal of cardiology</title><addtitle>Can J Cardiol</addtitle><description>Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in aortic stenosis patients. However, the factors associated with poorer outcomes among AF patients in contemporary TAVR practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, remain largely unknown.
Multicenter study including consecutive patients with a history of AF, evaluating the clinical outcomes and predictors of mortality, and HF-related hospitalization, who underwent TAVR with newer-generation devices using balloon or self-expandable valves.
A total of 3,476 patients were included. After a median follow-up of 2 (1-4) years, 36.4% had died, with 51.5% of deaths being cardiovascular-related, including 15.6% from HF. HF-related hospitalizations post-TAVR accounted for 34.8% of all hospitalizations and exhibited a significantly higher mortality risk (HR:1.54;95%CI:1.32-1.81;P<0.001). Permanent AF emerged as an independent predictor of all-cause death or HF-related hospitalizations (HR:1.25; 95%CI:1.10-1.40;P<0.001), as did other baseline characteristics, including chronic kidney disease (HR:1.23;95%CI:1.09-1.38;P=0.001), anemia (HR:1.21; 95%CI:1.07-1.36;P=0.002), and New York Heart Association class III or IV (HR:1.13; 95%CI:1.01-1.27;P=0.045). Additionally, early post-procedural complications, including stroke and bleeding also significantly increased the risk of mortality and HF-related hospitalizations (HR:5.52;95%CI:3.12-9.79;P<0.001 & HR:1.17;95%CI:1.03-1.33;P=0.014, respectively).
AF patients exhibited a high risk of HF-related hospitalizations in a contemporary TAVR cohort. Several baseline co-morbidities and periprocedural complications, along with permanent (vs. paroxysmal) AF were associated with poorer outcomes. These findings confirm the negative impact of AF despite the continued improvements in TAVR technology and underscore the importance of early intervention and optimization of HF management to improve outcomes in this high-risk population.
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Giovanni</creatorcontrib><creatorcontrib>Campelo-Parada, Francisco</creatorcontrib><creatorcontrib>Indolfi, Ciro</creatorcontrib><creatorcontrib>del Trigo, Maria</creatorcontrib><creatorcontrib>Munoz-Garcia, Antonio</creatorcontrib><creatorcontrib>Maneiro, Nicolas</creatorcontrib><creatorcontrib>Asmarats, Lluís</creatorcontrib><creatorcontrib>Reguiero, Ander</creatorcontrib><creatorcontrib>Del Val, David</creatorcontrib><creatorcontrib>Serra, Vicenç</creatorcontrib><creatorcontrib>Auffret, Vincent</creatorcontrib><creatorcontrib>Leroux, Lionel</creatorcontrib><creatorcontrib>Modine, Thomas</creatorcontrib><creatorcontrib>Mesnier, Jules</creatorcontrib><creatorcontrib>Suc, Gaspard</creatorcontrib><creatorcontrib>Avanzas, Pablo</creatorcontrib><creatorcontrib>Rezaei, Effar</creatorcontrib><creatorcontrib>Fradejas-Sastre, Victor</creatorcontrib><creatorcontrib>Tirado-Conte, Gabriela</creatorcontrib><creatorcontrib>Fernández-Nofrerias, Eduard</creatorcontrib><creatorcontrib>Angellotti, Domenico</creatorcontrib><creatorcontrib>Guitteny, Thibaut</creatorcontrib><creatorcontrib>Sorrentino, Sabato</creatorcontrib><creatorcontrib>Oteo, Juan Francisco</creatorcontrib><creatorcontrib>Díez-Delhoyo, Felipe</creatorcontrib><creatorcontrib>Gutiérrez-Alonso, Lola</creatorcontrib><creatorcontrib>Vidal, Pablo</creatorcontrib><creatorcontrib>Alfonso, Fernando</creatorcontrib><creatorcontrib>Monastyrski, Andrea</creatorcontrib><creatorcontrib>Nolf, Maxime</creatorcontrib><creatorcontrib>Avvedimento, Marisa</creatorcontrib><creatorcontrib>Rodés-Cabau, Josep</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Canadian journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mengi, Siddhartha</au><au>Cepas-Guillén, Pedro L.</au><au>Ternacle, Julien</au><au>Urena, Marina</au><au>Alperi, Alberto</au><au>Cheema, Asim N.</au><au>Veiga-Fernandez, Gabriela</au><au>Nombela-Franco, Luis</au><au>Vilata, Victoria</au><au>Esposito, Giovanni</au><au>Campelo-Parada, Francisco</au><au>Indolfi, Ciro</au><au>del Trigo, Maria</au><au>Munoz-Garcia, Antonio</au><au>Maneiro, Nicolas</au><au>Asmarats, Lluís</au><au>Reguiero, Ander</au><au>Del Val, David</au><au>Serra, Vicenç</au><au>Auffret, Vincent</au><au>Leroux, Lionel</au><au>Modine, Thomas</au><au>Mesnier, Jules</au><au>Suc, Gaspard</au><au>Avanzas, Pablo</au><au>Rezaei, Effar</au><au>Fradejas-Sastre, Victor</au><au>Tirado-Conte, Gabriela</au><au>Fernández-Nofrerias, Eduard</au><au>Angellotti, Domenico</au><au>Guitteny, Thibaut</au><au>Sorrentino, Sabato</au><au>Oteo, Juan Francisco</au><au>Díez-Delhoyo, Felipe</au><au>Gutiérrez-Alonso, Lola</au><au>Vidal, Pablo</au><au>Alfonso, Fernando</au><au>Monastyrski, Andrea</au><au>Nolf, Maxime</au><au>Avvedimento, Marisa</au><au>Rodés-Cabau, Josep</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Outcomes in Atrial Fibrillation Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices</atitle><jtitle>Canadian journal of cardiology</jtitle><addtitle>Can J Cardiol</addtitle><date>2024-12-10</date><risdate>2024</risdate><issn>0828-282X</issn><issn>1916-7075</issn><eissn>1916-7075</eissn><abstract>Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in aortic stenosis patients. However, the factors associated with poorer outcomes among AF patients in contemporary TAVR practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, remain largely unknown.
Multicenter study including consecutive patients with a history of AF, evaluating the clinical outcomes and predictors of mortality, and HF-related hospitalization, who underwent TAVR with newer-generation devices using balloon or self-expandable valves.
A total of 3,476 patients were included. After a median follow-up of 2 (1-4) years, 36.4% had died, with 51.5% of deaths being cardiovascular-related, including 15.6% from HF. HF-related hospitalizations post-TAVR accounted for 34.8% of all hospitalizations and exhibited a significantly higher mortality risk (HR:1.54;95%CI:1.32-1.81;P<0.001). Permanent AF emerged as an independent predictor of all-cause death or HF-related hospitalizations (HR:1.25; 95%CI:1.10-1.40;P<0.001), as did other baseline characteristics, including chronic kidney disease (HR:1.23;95%CI:1.09-1.38;P=0.001), anemia (HR:1.21; 95%CI:1.07-1.36;P=0.002), and New York Heart Association class III or IV (HR:1.13; 95%CI:1.01-1.27;P=0.045). Additionally, early post-procedural complications, including stroke and bleeding also significantly increased the risk of mortality and HF-related hospitalizations (HR:5.52;95%CI:3.12-9.79;P<0.001 & HR:1.17;95%CI:1.03-1.33;P=0.014, respectively).
AF patients exhibited a high risk of HF-related hospitalizations in a contemporary TAVR cohort. Several baseline co-morbidities and periprocedural complications, along with permanent (vs. paroxysmal) AF were associated with poorer outcomes. These findings confirm the negative impact of AF despite the continued improvements in TAVR technology and underscore the importance of early intervention and optimization of HF management to improve outcomes in this high-risk population.
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| fulltext | fulltext |
| identifier | ISSN: 0828-282X |
| ispartof | Canadian journal of cardiology, 2024-12 |
| issn | 0828-282X 1916-7075 1916-7075 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_04891625v1 |
| source | Elsevier ScienceDirect Journals |
| subjects | Cardiology and cardiovascular system Human health and pathology Life Sciences |
| title | Clinical Outcomes in Atrial Fibrillation Patients Undergoing Transcatheter Aortic Valve Replacement With Contemporary Devices |
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