In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sample
Background: Carotid artery stenosis (CAS) is a common occurrence in elderly patients undergoing transcatheter aortic valve replacement (TAVR). We conducted a retrospective study to identify the impact of CAS on in-hospital outcomes following TAVR. Methods: We queried the National Inpatient Sample (N...
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doaj-1d867d0686d34e51a34c81f9632e89682020-12-19T05:08:53ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672020-12-0131100621In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sampleSandipan Chakraborty0Md Faisaluddin1Kumar Ashish2Birendra Amgai3Dhrubajyoti Bandyopadhyay4Neelkumar Patel5Adrija Hajra6Gaurav Aggarwal7Raktim K. Ghosh8Ankur Kalra9Miami Valley Hospital, Dayton, OH, USADeccan College of Medical Sciences, Hyderabad, IndiaCrozer-Chester Medical Center, Philadelphia, USAInterfaith Medical Center, Brooklyn, NY, USAIcahn School of Medicine at Mount Sinai/Mount Sinai St Luke’s and West, Manhattan, NY, USA; Corresponding authors at: Icahn School of Medicine at Mount Sinai/Mount Sinai St Luke’s and West, 1000 10th Avenue, Manhattan, New York 10019 USA (D. Bandyopadhyay).Interfaith Medical Center, Brooklyn, NY, USAJacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, USAJersey City Medical Center, Jersey City, NJ, USAMedstar Union Memorial, Baltimore, MD, USACleveland Clinic Foundation, Akron General, Akron, OH, USABackground: Carotid artery stenosis (CAS) is a common occurrence in elderly patients undergoing transcatheter aortic valve replacement (TAVR). We conducted a retrospective study to identify the impact of CAS on in-hospital outcomes following TAVR. Methods: We queried the National Inpatient Sample (NIS) for 2016–2017 and identified patients who underwent TAVR with concomitant CAS using the ICD-10 codes. The primary endpoint of our study was in-hospital mortality and acute ischemic stroke. Results: We identified 80,740 TAVR-related hospitalizations. Of these, 6.9% (N = 5555) patients had concomitant CAS. The mean age for CAS patients was 80 ± 7.4 years. Females were represented equally in both groups. Traditional comorbidities like dyslipidemia [78.3% (N = 4350) vs. 68.2% (N = 51261); P < 0.001] and peripheral arterial disease [27.4% (N = 1525) vs. 12.7% (N = 9526); P < 0.001] were more frequently observed among CAS patients. Patients with CAS had higher rates of previous stroke [17.5% (N = 970) vs. 11.8% (N = 8902); P < 0.001] and CABG 23.8% (N = 1320) vs. 18.6% (N = 14022); P < 0.001]. Other cardiovascular risk factors were similar between the two groups. Moreover, no differences in in-hospital outcomes including mortality [odds ratio (OR): 1.35, CI: 0.48–3.83; P = 0.57] were observed in the propensity matched cohort. Conclusions: Our study did not find any major differences in outcomes in the CAS group following TAVR; however, a more detailed randomized controlled study with long-term follow-up of these patients is needed.http://www.sciencedirect.com/science/article/pii/S2352906720303195Transcatheter aortic valve replacement (TAVR)Carotid artery stenosis (CAS)StrokeIn-hospital mortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sandipan Chakraborty Md Faisaluddin Kumar Ashish Birendra Amgai Dhrubajyoti Bandyopadhyay Neelkumar Patel Adrija Hajra Gaurav Aggarwal Raktim K. Ghosh Ankur Kalra |
spellingShingle |
Sandipan Chakraborty Md Faisaluddin Kumar Ashish Birendra Amgai Dhrubajyoti Bandyopadhyay Neelkumar Patel Adrija Hajra Gaurav Aggarwal Raktim K. Ghosh Ankur Kalra In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sample International Journal of Cardiology: Heart & Vasculature Transcatheter aortic valve replacement (TAVR) Carotid artery stenosis (CAS) Stroke In-hospital mortality |
author_facet |
Sandipan Chakraborty Md Faisaluddin Kumar Ashish Birendra Amgai Dhrubajyoti Bandyopadhyay Neelkumar Patel Adrija Hajra Gaurav Aggarwal Raktim K. Ghosh Ankur Kalra |
author_sort |
Sandipan Chakraborty |
title |
In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sample |
title_short |
In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sample |
title_full |
In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sample |
title_fullStr |
In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sample |
title_full_unstemmed |
In-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: Insights from the national inpatient sample |
title_sort |
in-hospital clinical outcomes of transcatheter aortic valve replacement in patients with concomitant carotid artery stenosis: insights from the national inpatient sample |
publisher |
Elsevier |
series |
International Journal of Cardiology: Heart & Vasculature |
issn |
2352-9067 |
publishDate |
2020-12-01 |
description |
Background: Carotid artery stenosis (CAS) is a common occurrence in elderly patients undergoing transcatheter aortic valve replacement (TAVR). We conducted a retrospective study to identify the impact of CAS on in-hospital outcomes following TAVR. Methods: We queried the National Inpatient Sample (NIS) for 2016–2017 and identified patients who underwent TAVR with concomitant CAS using the ICD-10 codes. The primary endpoint of our study was in-hospital mortality and acute ischemic stroke. Results: We identified 80,740 TAVR-related hospitalizations. Of these, 6.9% (N = 5555) patients had concomitant CAS. The mean age for CAS patients was 80 ± 7.4 years. Females were represented equally in both groups. Traditional comorbidities like dyslipidemia [78.3% (N = 4350) vs. 68.2% (N = 51261); P < 0.001] and peripheral arterial disease [27.4% (N = 1525) vs. 12.7% (N = 9526); P < 0.001] were more frequently observed among CAS patients. Patients with CAS had higher rates of previous stroke [17.5% (N = 970) vs. 11.8% (N = 8902); P < 0.001] and CABG 23.8% (N = 1320) vs. 18.6% (N = 14022); P < 0.001]. Other cardiovascular risk factors were similar between the two groups. Moreover, no differences in in-hospital outcomes including mortality [odds ratio (OR): 1.35, CI: 0.48–3.83; P = 0.57] were observed in the propensity matched cohort. Conclusions: Our study did not find any major differences in outcomes in the CAS group following TAVR; however, a more detailed randomized controlled study with long-term follow-up of these patients is needed. |
topic |
Transcatheter aortic valve replacement (TAVR) Carotid artery stenosis (CAS) Stroke In-hospital mortality |
url |
http://www.sciencedirect.com/science/article/pii/S2352906720303195 |
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