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Association Between Pulmonary Hypertension and Transcatheter Aortic Valve Replacement: Analysis of a Nationwide Inpatient Sample Database

[ Vol. 14 , Issue. 1 ]

Author(s):

Dominika M Zoltowska*, Yashwant Agrawal, Nilesh Patel, Nishta Sareen , Jagadeesh K Kalavakunta, Vishal Gupta and Abdul Halabi   Pages 56 - 60 ( 5 )

Abstract:


Introduction: This study was done to review the association of pulmonary hypertension (PH) with Transcatheter Aortic Valve Replacement (TAVR) procedures done in the US for years 2010 to 2012.

Methods: We used Nationwide Inpatient Sample (NIS) data to extract data for patients who were hospitalized with a primary/secondary diagnosis of TAVR as specified by International Classification of Disease (ICD-9) codes 35.05 and 35.06. PH was identified with ICD-9 codes 416.0 and 416.8. Logistic regression models were used to analyze the association between PH and clinical outcomes of TAVR.

Results: A total of 8,824 weighted discharges were identified with a primary/secondary diagnosis of TAVR, of which 1,976 (22.4%) also had PH. Mean age of patients undergoing TAVR with and without PH was 81.4 and 81.1 years, respectively. More females had a diagnosis of PH with TAVR when compared to males, (56.9% vs. 43.1). When controlling for demographics, diabetes and hypertension; the association between PH and TAVR was statistically significant (p<.0001). Estimated odds of TAVR with PH was 5.46 (95% CI: 4.63, 6.41) times greater than for TAVR without PH. Similarly, the estimated odds for a length of stay greater than 1 week for TAVR with PH was 1.43 (95% CI: 1.12, 1.82; p=.0034) times greater than odds for TAVR without PH. PH was not statistically significant for in-hospital mortality in patients receiving TAVR (p=0.7067).

Conclusion: This study suggests that underlying PH does not influence the immediate mortality of patients underlying TAVR. Further studies are needed to delve into the bearing of PH on TAVR.

Keywords:

In-patient mortality, pulmonary hypertension, severe aortic stenosis, TAVR.

Affiliation:

Department of Internal Medicine, Western Michigan University Homer Stryker School of Medicine, 300 Portage Street, Kalamazoo, MI 49007, Department of Cardiology, St. Joseph Mercy Oakland Hospital, 44405 Woodward Ave, Pontiac, MI 48341, Department of Cardiology, St. Joseph Mercy Oakland Hospital, 44405 Woodward Ave, Pontiac, MI 48341, Department of Cardiology, St. Joseph Mercy Oakland Hospital, 44405 Woodward Ave, Pontiac, MI 48341, Department of Cardiology, Borgess Medical Center, 1521 Gull Rd, Kalamazoo, MI 49048, Department of Cardiology, Borgess Medical Center, 1521 Gull Rd, Kalamazoo, MI 49048, Department of Cardiology, St. Joseph Mercy Oakland Hospital, 44405 Woodward Ave, Pontiac, MI 48341



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