Catheterization and Cardiovascular Interventions最新文献

{"title":"Rotational Atherectomy Followed by Modified (Cutting or Scoring) Balloon Versus Plain Balloon Before Drug‑Eluting Stent Implantation for Calcified Coronary Lesions: A Meta-Analysis.","authors":"Basma Badrawy Khalefa, Mohammed Ayyad, Basel F Alqeeq, Maram Albandak, Alaa Ayyad, Ahmed K Awad, Ahmed R Gonnah, David H Roberts","doi":"10.1002/ccd.31380","DOIUrl":"https://doi.org/10.1002/ccd.31380","url":null,"abstract":"<p><p>Coronary calcification is a major factor leading to stent under-expansion, and subsequent adverse events. This meta-analysis aimed to evaluate the short and long‑term outcomes of rotational atherectomy (RA), followed by modified balloon (cutting or scoring) (MB) versus plain balloon before drug‑eluting stent implantation for calcified coronary lesions. We searched PubMed, Web of Science (WOS), Scopus, and the Cochrane Library Central Register of Controlled Trials (CENTRAL), from inception until 30 January 2024. The risk ratio (RR) with a 95% confidence interval (CI) was used to compare dichotomous outcomes, while continuous outcomes were reported in form of mean difference (MD). Our study included seven studies with 309 patients undergoing RA followed by MB angioplasty, and 414 patients had RA followed by conventional plain balloon angioplasty, before stent implantation. Our analysis revealed no significant difference in-hospital mortality (RR = 0.64, 95% CI [0.18, 2.23], p = 0.49), or long-term mortality (RR = 0.65, 95% CI [0.18, 2.36], p = 0.51). MACE were significantly lower in the cutting balloon group (RR = 0.58, 95% CI [0.37, 0.92], p = 0.02). Angiographic minimum lumen diameter, and change in percent diameter stenosis were significantly higher in the MB group (MD = 0.19, 95% CI [0.08, 0.31], p = < 0.01), and (MD = 3.75, 95% CI [0.76, 6.74], p = 0.01) respectively. No difference was found regarding target lesion revascularization (RR: 0.50, 95% CI [0.24, 1.04], p = 0.06), or target vessel revascularization (RR: 0.71, 95% CI [0.38, 1.33], p = 0.28). RA followed by MB is as safe plain balloon angioplasty before stent implantation in moderate to severely calcified coronary lesions. Moreover, it is associated with significantly better immediate angiographic outcomes, and significantly lower MACE.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Thresholds for Meaningful Health Status Changes Following Transfemoral Carotid Artery Stenting.","authors":"Jonathan Kluger, Gaëlle Romain, Carlos Mena-Hurtado, Scott Grubman, Carmen Pajarillo, Jacob Cleman, Lindsey Scierka, Kim G Smolderen","doi":"10.1002/ccd.31410","DOIUrl":"https://doi.org/10.1002/ccd.31410","url":null,"abstract":"<p><strong>Background: </strong>Evaluating health status changes following transfemoral carotid artery stenting (TF-CAS) is essential for assessing procedural success, but meaningful clinical changes are unknown. We aimed to determine minimal clinically important differences (MCIDs) and quantify health status improvement or worsening rates after TF-CAS using the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) registry data.</p><p><strong>Methods: </strong>The SAPPHIRE registry included patients undergoing TF-CAS from 2010 to 2014 for both symptomatic and asymptomatic carotid stenosis. Baseline and 30-day health status were assessed using the SF-36 (2010-2012) for mental and physical component scores (MCS and PCS) and the EQ-5D (2012-2014) for 3 L Index and Visual Analog Scale (VAS) scores. For each score, we calculated the 30-day distribution-based MCID (0.5*standard deviations of baseline health status) by symptom status and the overall cohort (symptom-weighted MCIDs). The changes were then categorized as improved, deteriorated, or unchanged based on these MCIDs.</p><p><strong>Results: </strong>Health status was assessed using the EQ-5D in 3930 patients and the SF-36 in 3018 patients (27.7% and 30.5% symptomatic, respectively). The MCIDs by symptom status were close, hence weighted MCIDs of 0.09 (Index), 11.00 (VAS), 4.70 (PCS), and 5.40 (MCS) were established. Across all subscales, 21.2%-26.1% of patients improved, 10.5%-16.7% worsened, and 57.2%-66.1% unchanged.</p><p><strong>Conclusions: </strong>We established thresholds for meaningful health status changes after TF-CAS using common generic instruments. At 30 days after TF-CAS, 70%-80% of patients no change or worsened, while 20%-30% improved. Carotid artery disease-specific instrument would provide better insights into of TF-CAS effects on health status.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"cHild -in-mothEr Approach for DeliverING Renal Denervation System: The HEADING-IN Technique.","authors":"Orazio Viola, Monica Verdoia, Manuela Mitro, Andrea Rognoni","doi":"10.1002/ccd.31406","DOIUrl":"https://doi.org/10.1002/ccd.31406","url":null,"abstract":"<p><p>Renal denervation is an emerging strategy for the management of uncontrolled hypertension. However, real-world experience is still modest, in particular for the management of complex anatomy, with available data being limited to the selected population of randomized clinical trials. We first describe the feasibility of delivering the renal denervation system to the target site with a child-in-mother technique, using a common coronary guiding extension, in a patient with severe tortuosity and double renal arteries.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Circulatory Support With Impella in High-Risk Patients With Chronic Total Occlusion and Complex Multivessel Disease.","authors":"Ignacio Gallo, Lorenzo Azzalini, Rafael González-Manzanares, Silvia Moscardelli, Alfonso Jurado-Román, Luis Carlos Maestre, Javier Suarez de Lezo, Francisco Hidalgo, Jorge Perea, Manuel Díaz, Soledad Ojeda, Manuel Pan","doi":"10.1002/ccd.31392","DOIUrl":"https://doi.org/10.1002/ccd.31392","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic management of patients with multivessel disease and severe left ventricular dysfunction is complex and controversial.</p><p><strong>Aims: </strong>The aim of this study was to analyze the clinical outcomes and the changes in left ventricular ejection fraction (LVEF) in patients with severe left ventricular dysfunction and at least one chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI) with hemodynamic support provided by Impella.</p><p><strong>Methods: </strong>Retrospective, multicenter study enrolling patients with severe left ventricular dysfunction and severe coronary artery disease with at least one CTO who required percutaneous mechanical circulatory support with Impella, from January 2019 to December 2023. The primary endpoints were the incidence of MACE (composite of cardiovascular death, acute myocardial infarct, and target lesion revascularization) at 90 days. The secondary endpoint was changes in LVEF and functional class during the same period.</p><p><strong>Results: </strong>A total of 27 patients (34 CTOs) were included in the study. The mean SYNTAX score was 35 ± 11. The median J-CTO score of 2 (1-3). At 90 day of follow-up, there were three MACE (11%), two cardiovascular deaths and one TLR; three vascular complications were related to access for the Impella device (only one required invasive treatment); and LVEF improved significantly after revascularization (delta LVEF: 10% [CI 95% 6, 15]). A total of 81% of patients improved their angina or dyspnea status at 90 days.</p><p><strong>Conclusions: </strong>In high-risk patients with severe left ventricular dysfunction with complex coronary disease including CTO, PCI with mechanical circulatory support using the Impella device is associated with favorable safety and efficacy outcomes at short-term follow-up.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Outcomes of Supera Interwoven Nitinol Versus Eluvia Fluoropolymer-Based Drug-Eluting Stents for the Treatment of Severely Calcified Femoropopliteal Artery Lesions: Results of the ELDORADO Study.","authors":"Takashi Yanagiuchi, Takahiro Tokuda, Naoki Yoshioka, Shunsuke Kojima, Akiko Tanaka, Tatsuro Takei, Kenji Ogata, Kohei Yamaguchi, Tatsuya Nakama, Hirokazu Yokoi","doi":"10.1002/ccd.31409","DOIUrl":"https://doi.org/10.1002/ccd.31409","url":null,"abstract":"<p><strong>Background: </strong>Supera interwoven nitinol stents (IWNS) and Eluvia fluoropolymer-based drug-eluting stents (DES) were designed to improve the patency of the femoropopliteal (FP) artery; however, which type of stent yields superior outcomes in calcified FP lesions remains unclear.</p><p><strong>Aims: </strong>To compare the safety and efficacy of Supera IWNS and Eluvia DES in severely calcified FP lesions.</p><p><strong>Methods: </strong>This study retrospectively analyzed 257 consecutive patients who underwent endovascular therapy using either IWNS (n = 123) or DES (n = 134) for FP lesions with peripheral arterial calcium scoring system (PACSS) grade 3 or 4 severe calcification between April 2018 and December 2021 at eight cardiovascular centers in Japan.</p><p><strong>Results: </strong>Propensity score (PS) matching extracted 138 matched patients with no remarkable intergroup difference in patient and lesion characteristics. The 1-year primary patency rates in the matched population were not significantly different between the IWNS and DES groups (85.4% vs. 89.8%, p = 0.320). A significant interaction between the stents used and the number of below-the-knee (BTK) runoff vessels was observed (interaction p = 0.048). The hazard ratio for restenosis was 2.68 (95% confidence interval, 0.51-14.2) in the group with no BTK runoff, favoring DES.</p><p><strong>Conclusion: </strong>In PS-matched patients with severely calcified FP lesions, 1-year primary patency was not significantly different between treatments using Supera IWNS and Eluvia DES.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Use of Post-Dilatation for Stent Optimization During Percutaneous Coronary Intervention; Results From the Netherlands Heart Registration.","authors":"K A J van Beek, M J C Timmermans, L Derks, J M Cheng, A O Kraaijeveld, E K Arkenbout, C E Schotborgh, J Brouwer, B E Claessen, E Lipsic, J Polad, L X van Nunen, K Sjauw, D van Veghel, P A Tonino, K Teeuwen","doi":"10.1002/ccd.31404","DOIUrl":"https://doi.org/10.1002/ccd.31404","url":null,"abstract":"<p><strong>Backgrounds: </strong>Post-dilatation after stenting with a non-compliant (NC) balloon can be used to improve overall percutaneous coronary intervention (PCI) result. Due to lack of evidence on the effect of post-dilatation on adverse clinical endpoints there is no consensus whether post-dilatation should be used routinely. The aim of the current study was to determine the contemporary practice of post-dilatation.</p><p><strong>Methods: </strong>This study included patients from the Netherlands Heart Registration who underwent PCI between the 4th quarter of 2020 and the 3rd quarter of 2021. The primary endpoint was the rate of post-dilatation with a NC balloon. Secondary endpoints included differences in baseline and procedural characteristics of patients that received post-dilatation and patients that did not receive post-dilatation.</p><p><strong>Results: </strong>Out of 12,960 patients from 11 hospitals, 49.9% underwent post-dilatation. There was a variety in post-dilatation between hospitals ranging from 29.3% to 82.7% and among operators ranging from 15.9% to 90.5%. Post-dilatation was used less frequent in patients presenting with ST-elevation myocardial infarction or out of hospital cardiac arrest. Multivessel and left main PCI, long stent length and use of intracoronary imaging and calcium modification were associated with increased use of post-dilatation. When imaging was used, the percentage of post-dilatation was 79.4%.</p><p><strong>Conclusions: </strong>In the Netherlands, stent optimization with post-dilatation using NC balloon is performed in only half of the patients undergoing PCI, with variations in frequency across centres and operators. Post-dilatation is more often used in cases of complex PCI and when intracoronary imaging or calcium modification techniques are used.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes According to the Extent of Atherosclerotic Disease in Female Patients Undergoing Transcatheter Aortic Valve Replacement: An Analysis From the WIN-TAVI Registry.","authors":"Benjamin Bay, Mauro Gitto, Samantha Sartori, Birgit Vogel, Didier Tchetche, Anna Sonia Petronio, Julinda Mehilli, Francesca Maria Di Muro, Thierry Lefevre, Patrizia Presbitero, Piera Capranzano, Angelo Oliva, Alessandro Iadanza, Pier Pasquale Leone, Gennaro Sardella, Nicolas M van Mieghem, Chan Joon Kim, Emanuele Meliga, Yihan Feng, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Maria-Cruz Ferrer-Gracia, Christoph Naber, Samin K Sharma, Yusuke Watanabe, Marie-Claude Morice, George D Dangas, Alaide Chieffo, Roxana Mehran","doi":"10.1002/ccd.31395","DOIUrl":"https://doi.org/10.1002/ccd.31395","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on the impact of polyvascular disease (PolyVD) on clinical outcomes in female patients undergoing transcatheter aortic valve replacement (TAVR). We therefore sought to investigate clinical outcomes in women with versus without PolyVD undergoing TAVR.</p><p><strong>Methods: </strong>Female participants from the multicentre Women's International Transcatheter Aortic Valve Implantation (WIN-TAVI) registry were categorized based on the presence or absence of PolyVD. The PolyVD population was defined as the presence of atherosclerotic disease affecting ≥ 2 arterial systems from coronary, cerebral, or lower limb peripheral vessels, whilst patients with either no atherosclerosis or atherosclerotic disease in one vascular system were included in the non-PolyVD population. The primary endpoint was the Valve Academic Research Consortium-2 consensus (VARC-2) efficacy endpoint at 1 year, whilst secondary endpoints included VARC-2 safety events, VARC-2 major bleeding and major vascular complications. Cox regression analysis were computed adjusting for various cofounders.</p><p><strong>Results: </strong>Among 996 participants, 543 (54.5%) had PolyVD, while 453 (45.5%) did not. Across the subgroups no differences in age was noted, whilst patients with PolyVD were more likely to have a history of hypercholesterolemia and a previous cardiac surgery. The incidence of the primary endpoint was higher in the PolyVD group (19.4%) compared to the non-PolyVD group (13.3%, p_log-rank = 0.014), though the difference was attenuated after multivariable adjustments (p = 0.093). Of note, no statistically significant differences concerning incident VARC-2 safety events, VARC-2 major bleeding and major vascular complications were noted according to PolyVD status.</p><p><strong>Conclusion: </strong>PolyVD is a common comorbidity and is associated with elevated rates of adverse clinical events, but no increase in safety events, vascular complications, or bleeding among women undergoing TAVR.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Sirolimus-Coated Balloon Angioplasty in De Novo Lesions in Large Coronary Vessels: A Propensity Score-Matched Study.","authors":"Cecilia Gobbi, Francesco Giangiacomi, Guido Pasero, Andrea Faggiano, Lucia Barbieri, Gabriele Tumminello, Federico Colombo, Massimiliano Ruscica, Valentina Ardizzone, Edoardo Genta, Luca Mircoli, Stefano Galli, Stefano Carugo","doi":"10.1002/ccd.31402","DOIUrl":"https://doi.org/10.1002/ccd.31402","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding drug-coated balloon (DCB)-only angioplasty in de novo lesions of large vessels is still limited and mainly focused on paclitaxel-coated balloon. We aimed to analyze the safety and efficacy of sirolimus-coated balloon (SCB)-only angioplasty in de novo lesions in large vessels compared to drug-eluting stent (DES).</p><p><strong>Methods: </strong>In this retrospective, dual-center, case-control study, we enrolled all consecutive patients treated between January 2022 and January 2024 with SCB-only angioplasty in de novo lesion in large vessel (> 2.75 mm) compared to a propensity-score matched contemporary population treated with DES. The primary endpoint was the rate of target lesion revascularization (TLR), while secondary endpoints were cardiac death (CD), target vessel revascularization (TVR), myocardial infarction (MI), and target lesion failure (TLF), defined as a composite of them.</p><p><strong>Results: </strong>The mean age was 70.1 ± 9.8 years in the SCB group (n = 92) and 67.9 ± 9.6 years in the DES group (n = 92) (p = 0.76). The median follow-up was 19.5 ± 12 months in the SCB group and 20.1 ± 13.1 months in the DES group (p = 0.47). TLR occurred in 6.7% of patients in the SCB group and 5.6% in the DES group (p = 0.75). The incidence of MI, TVR, and TLF were similar between the two groups (4.3% vs 3.3%, p = 0.7, 2.2% vs 3.4%, p = 0.65% and 9.8% vs 8.7%, p = 0.79). CD occurred in 4.3% in the SCB group, compared to 3.3% in the DES group (p = 0.70).</p><p><strong>Conclusion: </strong>Our study suggests that SCB angioplasty is both safe and effective in the treatment of de novo lesions of large vessels compared with DES.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve Thrombosis Following Transcatheter Aortic Valve Replacement: State-of-the-Art Review.","authors":"Fabiana Duarte, Inês Aguiar-Neves, Cláudio Espada Guerreiro, Mariana Silva, Nuno D Ferreira, Ricardo Fontes-Carvalho","doi":"10.1002/ccd.31393","DOIUrl":"https://doi.org/10.1002/ccd.31393","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) is a well-established treatment for severe aortic stenosis, especially in patients over 75 or those at high surgical risk. While these prosthetic valves have a lower thrombogenic profile than mechanical heart valves, leaflet thrombosis in transcatheter aortic valves (TAV) occurs in an estimated 5%-40% of cases. Most TAV thromboses are subclinical and can be detected via cardiac computed tomography (CCT), which reveals hypo-attenuating leaflet thickening and reduced leaflet motion in asymptomatic patients without elevated transprosthetic gradients on echocardiography. The mechanisms behind TAV thrombosis involve local mechanical triggers, patient predisposing factors, and device and procedure-related aspects. The ideal antithrombotic therapy post-TAVR depends on individual patient characteristics, balancing bleeding risks with the need for oral anticoagulants. Data on the optimal management of TAV thrombosis and the routine use of CT post-TAVR are limited. While anticoagulation effectively resolves clinically significant prosthesis thrombosis, its benefit in subclinical cases is unclear. There is an ongoing debate about whether subclinical leaflet thrombosis precedes clinical valve thrombosis, making the ideal follow-up after valve implantation uncertain. This article aims to provide a comprehensive review, summarizing current data on the incidence of TAVR thrombosis, underlying mechanisms, clinical and imaging diagnosis, management strategies, preventive measures, and long-term follow-up.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Cardiac Damage on In-Hospital Outcomes for Patients With Aortic Stenosis in the United States: An Analysis From The National Inpatient Sample.","authors":"Chun Shing Kwok, Sadie Bennett, Mithilesh Joshi, Adnan I Qureshi, Khaled Elsayed, Anikethana Appaji, Eric Holroyd, Philippe Pibarot, Bjorn Redfors, Philippe Genereux","doi":"10.1002/ccd.31399","DOIUrl":"https://doi.org/10.1002/ccd.31399","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to determine if cardiac damage based on hospital discharge codes is associated with in-hospital outcomes in patients with aortic stenosis (AS).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of hospital admissions between 2016 and 2021 with a diagnosis of AS in the National Inpatient Sample (NIS). The cardiac damage stages 0-4 were determined based on hospital discharge codes. Logistic and linear regressions were used to determine the association between cardiac stage and in-hospital mortality, length of stay (LoS) and cost.</p><p><strong>Results: </strong>A total of 2,980,150 hospital admissions were included in the analysis (82.5% conservative management, 11.2% transcatheter aortic valve replacement [TAVR], 6.3% surgical aortic valve replacement [SAVR]). The association between cardiac damage stage and in-hospital outcome was most significant for patients who had SAVR treatment (stage 4 vs. stage 0: mortality OR 27.70 95% CI 17.35-35.17, LoS 7.34 95% CI 6.34-8.35, cost 70,710 95% CI 65,110-76,310) compared to TAVR treatment (stage 4 vs. stage 0: mortality OR 9.15 95% CI 5.52-15.15, LoS 6.27 95% CI 5.63-6.90, cost 28,384 25,084 to 31,684) and conservative treatment (stage 4 vs. stage 0: mortality OR 3.55 95% CI 3.13-4.04, LoS 2.09 95% CI 1.87 to 2.31, cost 6362 95% CI 5642-7083).</p><p><strong>Conclusions: </strong>Cardiac damage can be evaluated using diagnostic codes in patients with AS and it is associated with in-hospital mortality, LoS and cost, and has more impact on these outcomes in patients treated with SAVR versus those treated with TAVR.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}