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

Byung Gyu Kim, Young Guk Ko, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Donghoon Choi, Yangsoo Jang, Myeongki Hong, Seung Hyun Lee, Sak Lee, Byung Chul Chang

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)206-211
Number of pages6
JournalInternational Journal of Cardiology
Volume255
DOIs
Publication statusPublished - 2018 Mar 15

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Peripheral Arterial Disease
Aortic Valve Stenosis
Mortality
Arteries
Blood Vessels
Transcatheter Aortic Valve Replacement
Confidence Intervals
Coronary Artery Disease
Lower Extremity
Pathologic Constriction
Thorax

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Byung Gyu ; Ko, Young Guk ; Hong, Sung Jin ; Ahn, Chul Min ; Kim, Jung Sun ; Kim, Byeong Keuk ; Choi, Donghoon ; Jang, Yangsoo ; Hong, Myeongki ; Lee, Seung Hyun ; Lee, Sak ; Chang, Byung Chul. / Impact of peripheral artery disease on early and late outcomes of transcatheter aortic valve implantation in patients with severe aortic valve stenosis. In: International Journal of Cardiology. 2018 ; Vol. 255. pp. 206-211.
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title = "Impact of peripheral artery disease on early and late outcomes of transcatheter aortic valve implantation in patients with severe aortic valve stenosis",
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.",
author = "Kim, {Byung Gyu} and Ko, {Young Guk} and Hong, {Sung Jin} and Ahn, {Chul Min} and Kim, {Jung Sun} and Kim, {Byeong Keuk} and Donghoon Choi and Yangsoo Jang and Myeongki Hong and Lee, {Seung Hyun} and Sak Lee and Chang, {Byung Chul}",
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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. / Kim, Byung Gyu; Ko, Young Guk; Hong, Sung Jin; Ahn, Chul Min; Kim, Jung Sun; Kim, Byeong Keuk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeongki; Lee, Seung Hyun; Lee, Sak; Chang, Byung Chul.

In: International Journal of Cardiology, Vol. 255, 15.03.2018, p. 206-211.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of peripheral artery disease on early and late outcomes of transcatheter aortic valve implantation in patients with severe aortic valve stenosis

AU - Kim, Byung Gyu

AU - Ko, Young Guk

AU - Hong, Sung Jin

AU - Ahn, Chul Min

AU - Kim, Jung Sun

AU - Kim, Byeong Keuk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Hong, Myeongki

AU - Lee, Seung Hyun

AU - Lee, Sak

AU - Chang, Byung Chul

PY - 2018/3/15

Y1 - 2018/3/15

N2 - 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.

AB - 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.

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