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Impact of peripheral artery disease on early and late outcomes of transcatheter aortic valve implantation in patients with severe aortic valve stenosis

Authors
 Byung Gyu Kim  ;  Young-Guk Ko  ;  Sung-Jin Hong  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong  ;  Seung Hyun Lee  ;  Sak Lee  ;  Byung-Chul Chang 
Citation
 International Journal of Cardiology, Vol.255 : 206-211, 2018 
Journal Title
 International Journal of Cardiology 
ISSN
 0167-5273 
Issue Date
2018
MeSH
Aged ; Aged, 80 and over ; Aortic Valve Stenosis/diagnostic imaging* ; Aortic Valve Stenosis/mortality ; Aortic Valve Stenosis/surgery* ; Computed Tomography Angiography/mortality ; Computed Tomography Angiography/trends ; Female ; Humans ; Male ; Mortality/trends ; Peripheral Arterial Disease/diagnostic imaging* ; Peripheral Arterial Disease/mortality ; Peripheral Arterial Disease/surgery* ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/mortality ; Registries ; Retrospective Studies ; Risk Factors ; Severity of Illness Index* ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/mortality ; Transcatheter Aortic Valve Replacement/trends* ; Treatment Outcome
Keywords
Aortic stenosis ; Clinical outcome ; Peripheral artery disease ; Transcatheter aortic valve implantation
Abstract
AIMS: Peripheral artery disease (PAD) is frequently present in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis. This study assessed the impact of PAD on clinical outcome after TAVI. METHODS: A total of 115 patients who underwent TAVI were evaluated retrospectively. Patients were divided into PAD and non-PAD groups, with PAD defined as stenosis≥50% in lower extremity arteries. Immediate and late clinical outcomes were compared between the two groups. RESULTS: PAD was present in 31.3% (36/115) of the patients undergoing TAVI. Compared to the non-PAD group, the PAD group had higher Society of Thoracic Surgeons' (STS) risk scores (8.83%±6.20% vs 6.23%±4.15%, p=0.039) and more frequent diagnoses of diabetes (52.8% vs 30.4%, p=0.021) and multi-vessel coronary artery disease (55.6% vs 29.1%, p=0.007). The PAD group also had higher incidence of major vascular complication (11.1% vs 1.3%, p=0.033), 30-day mortality (13.9% vs 1.3%, p<0.001), and subsequent 1-year (30.6% vs 3.8%, p<0.001) and 2-year (47.2% vs. 10.1%, p<0.001) all-cause mortality. PAD was identified as an independent predictor of increased 1-year mortality (hazard ratio [HR] 8.65; 95% confidence interval [CI], 1.05-71.14, p=0.045) after TAVI along with high STS score (HR 11.18, 95% CI 1.36-92.04, p=0.025). CONCLUSIONS: Presence of PAD was significantly associated with increased rates of major vascular complications as well as immediate and late mortality in patients undergoing TAVI. Assessment of PAD before TAVI is essential to choose an access strategy and to predict clinical results.
Full Text
https://www.sciencedirect.com/science/article/pii/S0167527317337154
DOI
10.1016/j.ijcard.2017.11.065
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
고영국(Ko, Young Guk) ORCID logo https://orcid.org/0000-0001-7748-5788
김병규(Kim, Byung Gyu)
김병극(Kim, Byeong Keuk) ORCID logo https://orcid.org/0000-0003-2493-066X
김중선(Kim, Jung Sun) ORCID logo https://orcid.org/0000-0003-2263-3274
안철민(Ahn, Chul-Min) ORCID logo https://orcid.org/0000-0002-7071-4370
이삭(Lee, Sak) ORCID logo https://orcid.org/0000-0001-6130-2342
이승현(Lee, Seung Hyun) ORCID logo https://orcid.org/0000-0002-0311-6565
장병철(Chang, Byung Chul)
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
홍명기(Hong, Myeong Ki) ORCID logo https://orcid.org/0000-0002-2090-2031
홍성진(Hong, Sung Jin) ORCID logo https://orcid.org/0000-0003-4893-039X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165499
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