Abstract 18377: The Relationship Between Heart Failure Readmission and Mortality in Patients Receiving Transcatheter Aortic Valve Implantation
Introduction: Symptomatic severe aortic stenosis (AS) is associated with significant morbidity and mortality. Transcatheter aortic valve implantation (TAVI) is an option for select high-risk patients with AS. We examined the 30-day and 1-year heart failure (HF) and non-HF hospitalization rates and their associated mortality rates.
Hypothesis: HF hospitalization post-TAVI is associated with higher mortality rates at 30-day and 1-year when compared to non-HF hospitalization.
Methods: We conducted a retrospective analysis of 535 TAVI patients between August 6th, 2010 and March 31st, 2014 at St. Paul’s Hospital, in Vancouver, BC. We used data from the CSBC TAVI registry, and linked this to the CIHI DAD and Vital Statistics for hospitalization and mortality.
Results: Within 1-year, 279 (52%) patients were hospitalized, of which 108 (20%) had a HF hospitalization (HFH), 171 (32%) had a non-HFH, and 256 (47%) were not hospitalized. There were no differences in age, sex, presence of severe COPD, and history of PCI, CABG and AVR. The pre-TAVI mean LVEF, AVA and gradients were not different between groups. The HFH cohort had more patients with baseline eGFR <60 (65% vs. 50% vs. 53%, p = 0.03), atrial fibrillation (52% vs. 31% vs. 31%, p = 0.001) and NYHA III/IV (94% vs. 80% vs. 87%, p = 0.003) when compared to the non-HFH and not hospitalized groups, respectively. The 30-day HFH and non-HFH rates were 9.0% and 10%, respectively, while the 1-year hospitalization rates were 21% and 35% for the HFH and non-HFH cohorts, respectively. The 30-day and 1-year all-cause mortality was 8% and 12% for the not hospitalized group, 0% and 9% for the non-HFH group, and 3% and 29% for the HFH group, respectively (p < 0.001 at 1-year).
Conclusions: Readmission rates post-TAVI is high, with 52% of patients requiring hospitalization within one year; with over one-third of these readmissions due to HF. Mortality rates were higher in patients with HFH at 30-days and 1-year when compared with patients with non-HFH.
Author Disclosures: H. Nazzari: None. N. Hawkins: None. S. Lauck: None. L. Ding: None. J. Polderman: None. M. Yu: None. O. Gerami: None. J. Ezekowitz: None. R. Boone: None. A. Cheung: None. J. Ye: None. D. Wood: None. J. Webb: None. M. Toma: None.
- © 2016 by American Heart Association, Inc.