Abstract 14665: The Impact of Glomerular Filtration Rates on the In-Hospital Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement: Insights of the Healthcare Cost and Utilization Project’s National Inpatient Sample
Background: Transcatheter aortic valve replacement (TAVR) is currently a Class I indication for the treatment of high surgical risk patients with severe symptomatic aortic stenosis.
Hypothesis: There is limited data on the impact of chronic kidney disease (CKD) in patients undergoing TAVR.
Methods: The Healthcare Cost and Utilization Project’s National Inpatient Sample was screened for hospital admissions of patients undergoing TAVR in 2003-2012. Patients were divided into 3 groups according to glomerular filtration rate (GFR): GFR >60 mL/min/1.73m2, GFR 15 to 59 mL/min/1.73m2, and GFR <15 mL/min/1.73m2. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), the composite of in-hospital death, acute myocardial infarction (AMI) and acute cerebrovascular accident (CVA).
Results: Data on 311 patients that underwent TAVR was available for analysis. Patients with a GFR >60 mL/min/1.73m2 were younger but there were no significant differences regarding other comorbidities. In hospital outcomes were similar in all three groups (Fig 1). In a multivariable analysis, increased age was a predictor of MACCE in patients with a GFR <15 mL/min/1.73m2 (OR 1.09, 95% CI 1.01-1.17) and patients with GFR >60 mL/min/1.73m2 (OR 1.08, 95% CI 1.01-1.16). However, GFR <15 mL/min/1.73m2 was not an independent predictor of MACCE.
Conclusions: In a contemporary database of patients undergoing TAVR, in-hospital outcomes were good, with low mortality and stroke rates. There seemed to be a numerically higher rate of in-hospital MACCE in patients with GFR <15 mL/min or stage 5 CKD; however, a GFR <15 mL/min was not an independent predictor of MACCE but age was a predictor of worse outcome.
Author Disclosures: F.V. Lima: None. T.Y. Yen: None. L. Gruberg: None.
- © 2015 by American Heart Association, Inc.