Zoltowska Dominika M, Agrawal Yashwant, Patel Nilesh, Sareen Nishtha, Kalavakunta Jagadeesh K, Gupta Vishal, Halabi Abdul
Department of Internal Medicine, Western Michigan University Homer Stryker School of Medicine, 300 Portage Street, Kalamazoo, MI 49007, United States.
Department of Cardiology, St. Joseph Mercy Oakland Hospital, 44405 Woodward Ave, Pontiac, MI 48341, United States.
Rev Recent Clin Trials. 2019;14(1):56-60. doi: 10.2174/1574887113666181120113034.
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.
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.
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).
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.
本研究旨在回顾2010年至2012年在美国进行的经导管主动脉瓣置换术（TAVR）与肺动脉高压（PH）之间的关联。
我们使用全国住院患者样本（NIS）数据，提取国际疾病分类（ICD-9）代码35.05和35.06指定的以TAVR为主/次要诊断而住院的患者的数据。PH通过ICD-9代码416.0和416.8确定。使用逻辑回归模型分析PH与TAVR临床结局之间的关联。
共识别出8824例加权出院病例，其主要/次要诊断为TAVR，其中1976例（22.4%）也患有PH。接受TAVR且患有和未患有PH的患者的平均年龄分别为81.4岁和81.1岁。与男性相比，更多女性在TAVR时被诊断患有PH（56.9%对43.1%）。在控制人口统计学、糖尿病和高血压后，PH与TAVR之间的关联具有统计学意义（p<0.0001）。患有PH的TAVR的估计比值比是未患有PH的TAVR的5.46倍（95%置信区间：4.63，6.41）。同样，患有PH的TAVR住院时间超过1周的估计比值比是未患有PH的TAVR的1.43倍（95%置信区间：1.12，1.82；p = 0.0034）。PH对接受TAVR患者的院内死亡率无统计学意义（p = 0.7067）。
本研究表明，潜在的PH不影响接受TAVR患者的即时死亡率。需要进一步研究深入探讨PH对TAVR的影响。
