Urgent Transcatheter Mitral Edge-to-Edge Repair Is Associated With Worse in-Hospital Outcomes: A Nationwide Analysis

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-03-10 DOI:10.1002/clc.70067

Carlos Diaz-Arocutipa, Cesar Joel Benites-Moya, Javier Torres-Valencia, Adhya Mehta, Lourdes Vicent

{"title":"Urgent Transcatheter Mitral Edge-to-Edge Repair Is Associated With Worse in-Hospital Outcomes: A Nationwide Analysis","authors":"Carlos Diaz-Arocutipa, Cesar Joel Benites-Moya, Javier Torres-Valencia, Adhya Mehta, Lourdes Vicent","doi":"10.1002/clc.70067","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>To assess in-hospital outcomes in patients undergoing urgent versus non-urgent transcatheter mitral edge-to-edge repair (TEER).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We used the NIS database 2016−2019 to include admissions who underwent TEER. Inverse probability of treatment weighting (IPTW) was used to compare urgent versus non-urgent groups.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 29 730 weighted admissions were included, of whom 21.6% were urgent admissions. Urgent admissions had a higher risk of in-hospital mortality (risk ratio [RR] 3.67, 95% confidence interval [CI] 2.39−5.62), cardiogenic shock (RR 4.95, 95% CI 3.73−6.57), intra-aortic balloon pump (RR 3.97, 95% CI 2.53−6.23), percutaneous ventricular assist device (RR 17.24, 95% CI 6.37−46.66), mechanical ventilation (RR 3.79, 95% CI 2.80−5.11), acute stroke (RR 2.56, 95% CI 1.32−4.97), in-hospital cardiac arrest (RR 2.25, 95% CI 1.08−4.69), major bleeding (RR 5.18, 95% CI 2.97−9.06), increased length of stay (6 vs. 2 days, <i>p</i> < 0.001), and higher total costs ($229 160 vs. $164 653, <i>p</i> < 0.01) compared to non-urgent admissions. There was no difference between both groups for renal replacement therapy and pericardial complication.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Our results suggest that urgent TEER implantation was associated with an increased risk of in-hospital death and other short-term complications.</p>\n </section>\n </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"48 3","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70067","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Cardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/clc.70067","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

To assess in-hospital outcomes in patients undergoing urgent versus non-urgent transcatheter mitral edge-to-edge repair (TEER).

Methods

We used the NIS database 2016−2019 to include admissions who underwent TEER. Inverse probability of treatment weighting (IPTW) was used to compare urgent versus non-urgent groups.

Results

A total of 29 730 weighted admissions were included, of whom 21.6% were urgent admissions. Urgent admissions had a higher risk of in-hospital mortality (risk ratio [RR] 3.67, 95% confidence interval [CI] 2.39−5.62), cardiogenic shock (RR 4.95, 95% CI 3.73−6.57), intra-aortic balloon pump (RR 3.97, 95% CI 2.53−6.23), percutaneous ventricular assist device (RR 17.24, 95% CI 6.37−46.66), mechanical ventilation (RR 3.79, 95% CI 2.80−5.11), acute stroke (RR 2.56, 95% CI 1.32−4.97), in-hospital cardiac arrest (RR 2.25, 95% CI 1.08−4.69), major bleeding (RR 5.18, 95% CI 2.97−9.06), increased length of stay (6 vs. 2 days, p < 0.001), and higher total costs ($229 160 vs. $164 653, p < 0.01) compared to non-urgent admissions. There was no difference between both groups for renal replacement therapy and pericardial complication.

Conclusion

Our results suggest that urgent TEER implantation was associated with an increased risk of in-hospital death and other short-term complications.

Abstract Image

查看原文本刊更多论文

紧急经导管二尖瓣边缘到边缘修复与较差的住院结果相关：一项全国分析

背景：评估急诊与非急诊经导管二尖瓣边缘修复（TEER）患者的住院结果。方法使用NIS数据库2016 - 2019纳入接受TEER治疗的入院患者。使用治疗加权逆概率（IPTW）来比较紧急组和非紧急组。结果共纳入29730名加权入院患者，其中紧急入院患者占21.6%。急诊住院患者的院内死亡风险较高（风险比[RR] 3.67, 95%可信区间[CI] 2.39 ~ 5.62）、心源性休克（RR 4.95, 95% CI 3.73 ~ 6.57）、主动脉内球囊泵（RR 3.97, 95% CI 2.53 ~ 6.23）、经皮心室辅助装置（RR 17.24, 95% CI 6.37 ~ 46.66）、机械通气（RR 3.79, 95% CI 2.80 ~ 5.11）、急性卒中（RR 2.56, 95% CI 1.32 ~ 4.97）、院内心脏骤停（RR 2.25, 95% CI 1.08 ~ 4.69）、大出血（RR 5.18, 95% CI 2.97 ~ 9.06）、与非紧急住院相比，住院时间更长（6天对2天，p < 0.001），总费用更高（229 160美元对164 653美元，p < 0.01）。两组在肾脏替代治疗和心包并发症方面无差异。结论急诊TEER植入与院内死亡和其他短期并发症的风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.