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Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly offered for aortic stenosis (AS) treatment in patients with a history of cancer. The impact of frailty on outcomes in this specific patient population is not well described. HYPOTHESIS: Frailty is associated with mortality and...

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Autores principales: Kosaraju, Nikitha, Wu, Perry, Leng, Mei, Bolano, Marielle, Rafique, Asim M., Shen, John, Satou, Nancy, Huchting, Jeanne, Goldwater, Deena, Aksoy, Olcay, Yang, Eric H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574730/
https://www.ncbi.nlm.nih.gov/pubmed/36193709
http://dx.doi.org/10.1002/clc.23927
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author Kosaraju, Nikitha
Wu, Perry
Leng, Mei
Bolano, Marielle
Rafique, Asim M.
Shen, John
Satou, Nancy
Huchting, Jeanne
Goldwater, Deena
Aksoy, Olcay
Yang, Eric H.
author_facet Kosaraju, Nikitha
Wu, Perry
Leng, Mei
Bolano, Marielle
Rafique, Asim M.
Shen, John
Satou, Nancy
Huchting, Jeanne
Goldwater, Deena
Aksoy, Olcay
Yang, Eric H.
author_sort Kosaraju, Nikitha
collection PubMed
description BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly offered for aortic stenosis (AS) treatment in patients with a history of cancer. The impact of frailty on outcomes in this specific patient population is not well described. HYPOTHESIS: Frailty is associated with mortality and poorer quality of life (QOL) outcomes in patients undergoing TAVR with a history of cancer. METHODS: This retrospective single center cohort study included AS patients who underwent TAVR from August 1, 2012 to May 15, 2020. Frailty was measured using serum albumin, hemoglobin, gait speed, functional dependence, and cognitive impairment. The primary outcome was a composite of all‐cause mortality and QOL at 1 year. A poor primary outcome was defined as either all‐cause mortality, Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ‐OS) score <45 or a KCCQ‐OS score decline of ≥10 points from baseline. Regression analysis was used to determine the impact of frailty on the primary outcome. RESULTS: The study population was stratified into active/recent cancer (n = 107), remote cancer (n = 85), and non‐cancer (n = 448). Univariate analysis of each cohort showed that frailty was associated with the primary outcome only in the non‐cancer cohort (p = .004). Multivariate analysis showed that cancer history was not associated with a poor primary outcome, whereas frailty was (1.7 odds ratio, 95% confidence interval [CI]: 1.1–2.8; p = .028). CONCLUSIONS: Frailty is associated with mortality and poor QOL in the overall and non‐cancer cohorts. Further investigation is warranted to understand frailty's effect on the cancer population. Frailty should be heavily considered during TAVR evaluation.
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spelling pubmed-95747302022-10-17 Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement Kosaraju, Nikitha Wu, Perry Leng, Mei Bolano, Marielle Rafique, Asim M. Shen, John Satou, Nancy Huchting, Jeanne Goldwater, Deena Aksoy, Olcay Yang, Eric H. Clin Cardiol Clinical Trial Result BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly offered for aortic stenosis (AS) treatment in patients with a history of cancer. The impact of frailty on outcomes in this specific patient population is not well described. HYPOTHESIS: Frailty is associated with mortality and poorer quality of life (QOL) outcomes in patients undergoing TAVR with a history of cancer. METHODS: This retrospective single center cohort study included AS patients who underwent TAVR from August 1, 2012 to May 15, 2020. Frailty was measured using serum albumin, hemoglobin, gait speed, functional dependence, and cognitive impairment. The primary outcome was a composite of all‐cause mortality and QOL at 1 year. A poor primary outcome was defined as either all‐cause mortality, Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ‐OS) score <45 or a KCCQ‐OS score decline of ≥10 points from baseline. Regression analysis was used to determine the impact of frailty on the primary outcome. RESULTS: The study population was stratified into active/recent cancer (n = 107), remote cancer (n = 85), and non‐cancer (n = 448). Univariate analysis of each cohort showed that frailty was associated with the primary outcome only in the non‐cancer cohort (p = .004). Multivariate analysis showed that cancer history was not associated with a poor primary outcome, whereas frailty was (1.7 odds ratio, 95% confidence interval [CI]: 1.1–2.8; p = .028). CONCLUSIONS: Frailty is associated with mortality and poor QOL in the overall and non‐cancer cohorts. Further investigation is warranted to understand frailty's effect on the cancer population. Frailty should be heavily considered during TAVR evaluation. John Wiley and Sons Inc. 2022-10-04 /pmc/articles/PMC9574730/ /pubmed/36193709 http://dx.doi.org/10.1002/clc.23927 Text en © 2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Trial Result
Kosaraju, Nikitha
Wu, Perry
Leng, Mei
Bolano, Marielle
Rafique, Asim M.
Shen, John
Satou, Nancy
Huchting, Jeanne
Goldwater, Deena
Aksoy, Olcay
Yang, Eric H.
Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement
title Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement
title_full Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement
title_fullStr Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement
title_full_unstemmed Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement
title_short Impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement
title_sort impact of frailty on mortality and quality of life in patients with a history of cancer undergoing transcatheter aortic valve replacement
topic Clinical Trial Result
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574730/
https://www.ncbi.nlm.nih.gov/pubmed/36193709
http://dx.doi.org/10.1002/clc.23927
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