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National Trends and Outcomes of Acute Myocardial Infarction After Transcatheter Aortic Valve Replacement.
Gupta, Tanush; Zimmer, Joshua; Lahoud, Rony N; Murphy, Hannah R; Harris, Alyssa H; Kolte, Dhaval; Hirashima, Fuyuki; Dauerman, Harold L.
Afiliación
  • Gupta T; Division of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA.
  • Zimmer J; Division of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA.
  • Lahoud RN; Division of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA.
  • Murphy HR; Center for Advanced Analytics and Informatics, Vizient, Irving, Texas, USA.
  • Harris AH; Center for Advanced Analytics and Informatics, Vizient, Irving, Texas, USA.
  • Kolte D; Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Hirashima F; Division of Cardiothoracic Surgery, University of Vermont Medical Center, Burlington, Vermont, USA.
  • Dauerman HL; Division of Cardiology, University of Vermont Medical Center, Burlington, Vermont, USA. Electronic address: harold.dauerman@uvmhealth.org.
JACC Cardiovasc Interv ; 17(10): 1267-1276, 2024 May 27.
Article en En | MEDLINE | ID: mdl-38530682
ABSTRACT

BACKGROUND:

Prior studies have reported decreased use of an invasive approach for acute myocardial infarction (AMI) in patients undergoing transcatheter aortic valve replacement (TAVR).

OBJECTIVES:

The aim of this study was to determine whether prior TAVR affects the use of subsequent coronary revascularization and outcomes of AMI in a contemporary national data set.

METHODS:

Consecutive TAVR patients from 2016 to 2022 were identified from the U.S. Vizient Clinical Data Base who were hospitalized after the index TAVR hospitalization with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). Patients with STEMI or NSTEMI with or without prior TAVR from the same time period were compared for the use of coronary angiography, revascularization, and in-hospital outcomes. Propensity score matching was used to account for imbalances in patient characteristics.

RESULTS:

Among 206,229 patients who underwent TAVR, the incidence of STEMI was 25 events per 100,000 person-years of follow-up, and that of NSTEMI was 229 events per 100,000 person-years. After propensity matching, the use of coronary revascularization was similar in the prior TAVR and no TAVR cohorts in both the STEMI (65.3% vs 63.9%; P = 0.81) and NSTEMI (41.4% vs 41.7%; P = 0.88) subgroups. Compared with patients without prior TAVR, in-hospital mortality was higher in the prior TAVR cohort in patients with STEMI (27.1% vs 16.7%; P = 0.03) and lower in those with NSTEMI (5.8% vs 8.2%; P = 0.02).

CONCLUSIONS:

In this large, national retrospective study, AMI events after TAVR were infrequent. There were no differences in the use of coronary revascularization for STEMI or NSTEMI in TAVR patients compared with the non-TAVR population. In-hospital mortality for STEMI is higher in TAVR patients compared with those without prior TAVR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Bases de Datos Factuales / Mortalidad Hospitalaria / Reemplazo de la Válvula Aórtica Transcatéter / Infarto del Miocardio sin Elevación del ST / Infarto del Miocardio con Elevación del ST Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Bases de Datos Factuales / Mortalidad Hospitalaria / Reemplazo de la Válvula Aórtica Transcatéter / Infarto del Miocardio sin Elevación del ST / Infarto del Miocardio con Elevación del ST Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos