Readmission Trends and Outcomes of Transcatheter Edge-to-Edge Repair of Mitral Regurgitation With and Without Atrial Fibrillation: A Propensity-Matched National Readmission Analysis.

Q3 Medicine

Critical Pathways in Cardiology Pub Date : 2025-05-14 DOI:10.1097/HPC.0000000000000393

Saliha Erdem, Amro Taha, Neel Patel, Anoop Titus, Muhammad Aamir, Yasemin Bahar, Yasar Sattar, Khola Waheed Khan, Waleed Alruwaili, Aneeza Jamshed, Nagib Chalfoun, Islam Y Elgendy, M Chadi Alraies

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引用次数: 0

Abstract

Background: The use of transcatheter edge-to-edge repair (TEER) for symptomatic mitral regurgitation is steadily increasing. However, the outcomes of TEER among patients with atrial fibrillation (AF), including readmission trends, remain unknown.

Methods: The Nationwide Readmissions Database was queried between 2016 to 2020 to identify TEER patients with and without AF. The two groups were then compared using propensity score matching (PSM) and multivariate regression models. The outcomes included in-hospital mortality, acute kidney injury (AKI), heart failure, acute stroke, myocardial infarction (MI), post-procedure bleeding (PPB), and cardiac tamponade.

Results: A total of 39,867 TEER procedure recipients were included over the study period, of which, 24,729 (62%) had AF compared to 15,138 (38%) with no AF diagnosis. On adjusted analysis, the AF group had a higher rate of inpatient mortality, AKI, heart failure (HF), and post-procedural bleeding (PPB). On the contrary, TEER with AF group had lower odds of MI. The risk of stroke and cardiac tamponade were similar between the two groups. The median length of stay (LOS) at index hospitalization was longer in the AF cohort in comparison with those without (2 days (IQR 5-1) vs 1 day (IQR 3-1)).

Conclusion: AF in TEER procedure recipients was associated with worse outcomes including a higher rate of inpatient mortality, AKI, and HF compared to the patients without AF. Readmission rates at 30, 90, and 180 days were similar between the two groups.

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伴有和不伴有房颤的二尖瓣反流经导管边缘对边缘修复的再入院趋势和结果：一项倾向匹配的国家再入院分析

背景：经导管边缘到边缘修复（TEER）治疗症状性二尖瓣反流的应用正在稳步增加。然而，心房颤动（AF）患者的TEER结果，包括再入院趋势，仍然未知。方法：查询2016年至2020年全国再入院数据库，以确定合并和不合并AF的TEER患者。然后使用倾向评分匹配（PSM）和多变量回归模型对两组患者进行比较。结果包括住院死亡率、急性肾损伤（AKI）、心力衰竭、急性卒中、心肌梗死（MI）、术后出血（PPB）和心包填塞。结果：在研究期间共纳入39,867例TEER手术受术者，其中24,729例（62%）患有房颤，而15,138例（38%）无房颤诊断。经调整分析，房颤组住院死亡率、AKI、心力衰竭（HF）和术后出血（PPB）的发生率更高。相反，TEER合并AF组心肌梗死发生率较低，卒中和心包填塞风险两组相近。房颤组的指数住院中位时间（LOS）较未住院组更长（2天（IQR 5-1） vs 1天（IQR 3-1））。结论：与没有房颤的患者相比，TEER手术受者房颤与较差的预后相关，包括更高的住院死亡率、AKI和HF。两组在30,90和180天的再入院率相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Pathways in Cardiology Medicine-Medicine (all)

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Critical Pathways in Cardiology provides a single source for the diagnostic and therapeutic protocols in use at hospitals worldwide for patients with cardiac disorders. The Journal presents critical pathways for specific diagnoses—complete with evidence-based rationales—and also publishes studies of these protocols" effectiveness.