接受经导管主动脉瓣植入术的女性基线左心室射血分数对中期预后的影响:来自 WIN TAVI 注册的启示。

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Francesca Maria Di Muro MD , Birgit Vogel MD , Samantha Sartori PhD , Didier Tchetche MD , Yihan Feng MS , Anna Sonia Petronio MD , Julinda Mehilli MD , Benjamin Bay MD , Mauro Gitto MD , Thierry Lefevre MD , Patrizia Presbitero MD , Piera Capranzano MD , Angelo Oliva MD , Alessandro Iadanza MD , Gennaro Sardella MD , Nicolas Van Mieghem MD, PhD , Emanuele Meliga MD , Pier Pasquale Leone MD , Nicolas Dumonteil MD , Chiara Fraccaro MD, PhD , Roxana Mehran MD
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引用次数: 0

摘要

在接受经导管主动脉瓣植入术(TAVI)的女性患者中,基线左心室射血分数(LVEF)对预后影响的证据有限,我们在本次分析中旨在研究这一点。WIN-TAVI 登记处根据基线 LVEF 将患者分为三组:降低(LVEF≤40%)、轻度降低(40%< LVEF
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Baseline Left Ventricular Ejection Fraction on Midterm Outcomes in Women Undergoing Transcatheter Aortic Valve Implantation: Insight from the WIN-TAVI Registry
Limited evidence exists concerning the prognostic impact of baseline left ventricular ejection fraction (LVEF) on outcomes among women undergoing transcatheter aortic valve implantation (TAVI), which we aimed to investigate in the present analysis. Patients from the Women's International Transcatheter Aortic Valve Implantation (WIN-TAVI) registry were categorized according to baseline LVEF into 3 groups: reduced (LVEF ≤40%), mildly reduced (LVEF between 41% and 49%), and preserved (LVEF ≥50%) LVEF. The primary (Valve Academic Research Consortium 2 [VARC-2]) efficacy point was defined as a composite of mortality, stroke, myocardial infarction, hospitalization for valve-related symptoms or heart failure, or valve-related dysfunction at 1 year. The primary (VARC-2) safety end point included all-cause mortality, stroke, major vascular complication, life-threatening bleeding, stage 2 to 3 acute kidney injury, coronary artery obstruction requiring intervention, or valve-related dysfunction requiring repeated procedures. A Cox regression model was performed using the preserved LVEF group as the reference. Among the 944 patients included, 764 (80.9%) exhibited preserved, 80 (8.5%) had mildly reduced, and 100 (10.6%) had reduced LVEF. The 1-year incidence of VARC-2 efficacy end point was numerically higher in patients with reduced LVEF, albeit not resulting in a significant risk difference. Notably, reduced LVEF was associated with a higher risk of the 1-year VARC-2 safety end point, still significant after adjustment (28.0% vs 19.6%, Hazard Ratio 1.78, 95% Confidence Interval 1.12- 2.82, p = 0.014). These differences were primarily driven by trends toward increased rates of all-cause mortality, cardiovascular mortality, and major vascular complications. Clinical outcomes were similar between patients with mildly reduced and preserved LVEF. In conclusion, when performed in women with reduced LVEF, TAVI was associated with a worse (VARC-2) safety profile at 1-year follow-up. In contrast, patients with mildly reduced LVEF appeared to align more closely with outcomes observed in the preserved LVEF group than with the reduced LVEF group.
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来源期刊
American Journal of Cardiology
American Journal of Cardiology 医学-心血管系统
CiteScore
4.00
自引率
3.60%
发文量
698
审稿时长
33 days
期刊介绍: Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.
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