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Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization

Objective Our study aimed to assess the risk of in-patient mortality due to renal failure and other comorbidities in aortic stenosis (AS) patients undergoing transcatheter aortic valve replacement (TAVR). Methods We conducted a cross-sectional study using a Nationwide Inpatient Sample (NIS, January...

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Autores principales: Kaur, Pawandeep, Ajibawo, Temitope, Yomi, Timiiye, Patel, Neev, Baksh, Mizba, Okotcha, Edmond, Kataria, Saurabh, Patel, Rikinkumar S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445110/
https://www.ncbi.nlm.nih.gov/pubmed/32850251
http://dx.doi.org/10.7759/cureus.9384
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author Kaur, Pawandeep
Ajibawo, Temitope
Yomi, Timiiye
Patel, Neev
Baksh, Mizba
Okotcha, Edmond
Kataria, Saurabh
Patel, Rikinkumar S
author_facet Kaur, Pawandeep
Ajibawo, Temitope
Yomi, Timiiye
Patel, Neev
Baksh, Mizba
Okotcha, Edmond
Kataria, Saurabh
Patel, Rikinkumar S
author_sort Kaur, Pawandeep
collection PubMed
description Objective Our study aimed to assess the risk of in-patient mortality due to renal failure and other comorbidities in aortic stenosis (AS) patients undergoing transcatheter aortic valve replacement (TAVR). Methods We conducted a cross-sectional study using a Nationwide Inpatient Sample (NIS, January 2010 to December 2014) from the United States and included 33,325 patients with a primary diagnosis of AS. Logistic regression was used to evaluate the odds ratio (OR) for in-hospital mortality in AS by comorbidities including renal failure. Results The prevalence of renal failure in AS patients is 29.2%, and a higher proportion were males (60.1%) and non-white (14.1%). Major loss of function (96.6%) and in-hospital mortality (5.1%) were also proportionally higher in prevalence. Female patients (OR 1.35, 95% CI 1.20-1.51) had higher odds of in-patient mortality in AS patients. Race was a non-significant predictor for mortality risk. Patients with comorbid coagulopathy (OR 2.02, 95% CI 1.79-2.27) and heart failure (OR 1.62, 95% CI 1.39-1.89) have increased mortality in AS inpatients. After controlling confounders, renal failure was significantly associated with increased in-hospital mortality (OR 1.43, 95% CI 1.28-1.61) in AS patients. Conclusion Renal failure was prevalent in AS patients and was an independent factor that increases the risk of in-hospital mortality by 43%. Due to worse outcomes, more studies are required to evaluate risk-benefit ratio and strategies to improve health-related quality of life in post-TAVR patients with renal failure, and optimally decrease inpatient mortality.
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spelling pubmed-74451102020-08-25 Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization Kaur, Pawandeep Ajibawo, Temitope Yomi, Timiiye Patel, Neev Baksh, Mizba Okotcha, Edmond Kataria, Saurabh Patel, Rikinkumar S Cureus Cardiology Objective Our study aimed to assess the risk of in-patient mortality due to renal failure and other comorbidities in aortic stenosis (AS) patients undergoing transcatheter aortic valve replacement (TAVR). Methods We conducted a cross-sectional study using a Nationwide Inpatient Sample (NIS, January 2010 to December 2014) from the United States and included 33,325 patients with a primary diagnosis of AS. Logistic regression was used to evaluate the odds ratio (OR) for in-hospital mortality in AS by comorbidities including renal failure. Results The prevalence of renal failure in AS patients is 29.2%, and a higher proportion were males (60.1%) and non-white (14.1%). Major loss of function (96.6%) and in-hospital mortality (5.1%) were also proportionally higher in prevalence. Female patients (OR 1.35, 95% CI 1.20-1.51) had higher odds of in-patient mortality in AS patients. Race was a non-significant predictor for mortality risk. Patients with comorbid coagulopathy (OR 2.02, 95% CI 1.79-2.27) and heart failure (OR 1.62, 95% CI 1.39-1.89) have increased mortality in AS inpatients. After controlling confounders, renal failure was significantly associated with increased in-hospital mortality (OR 1.43, 95% CI 1.28-1.61) in AS patients. Conclusion Renal failure was prevalent in AS patients and was an independent factor that increases the risk of in-hospital mortality by 43%. Due to worse outcomes, more studies are required to evaluate risk-benefit ratio and strategies to improve health-related quality of life in post-TAVR patients with renal failure, and optimally decrease inpatient mortality. Cureus 2020-07-25 /pmc/articles/PMC7445110/ /pubmed/32850251 http://dx.doi.org/10.7759/cureus.9384 Text en Copyright © 2020, Kaur et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Kaur, Pawandeep
Ajibawo, Temitope
Yomi, Timiiye
Patel, Neev
Baksh, Mizba
Okotcha, Edmond
Kataria, Saurabh
Patel, Rikinkumar S
Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization
title Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization
title_full Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization
title_fullStr Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization
title_full_unstemmed Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization
title_short Aortic Stenosis Patients With Transcatheter Aortic Valve Replacement: Caution Recommended With Renal Failure During Hospitalization
title_sort aortic stenosis patients with transcatheter aortic valve replacement: caution recommended with renal failure during hospitalization
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445110/
https://www.ncbi.nlm.nih.gov/pubmed/32850251
http://dx.doi.org/10.7759/cureus.9384
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