Risk factors for early mortality following transcatheter edge-to-edge repair of mitral regurgitation.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Revascularization Medicine Pub Date : 2024-08-15 DOI:10.1016/j.carrev.2024.08.001
Yong-Hao Yeo, Jia-Yean Thong, Min-Choon Tan, Qi-Xuan Ang, Boon-Jian San, Bryan E-Xin Tan, Arka Chatterjee, Kwan Lee
{"title":"Risk factors for early mortality following transcatheter edge-to-edge repair of mitral regurgitation.","authors":"Yong-Hao Yeo, Jia-Yean Thong, Min-Choon Tan, Qi-Xuan Ang, Boon-Jian San, Bryan E-Xin Tan, Arka Chatterjee, Kwan Lee","doi":"10.1016/j.carrev.2024.08.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>While transcatheter edge-to-edge repair (TEER) with MitraClip is increasingly used, data on the risk stratification for assessing early mortality after this procedure are scarce.</p><p><strong>Objective: </strong>This study aimed to assess early mortality and analyze the risk factors of early mortality among patients who underwent TEER.</p><p><strong>Methods: </strong>Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged 18 years or older who had TEER between January 2017 and November 2020. We categorized the cohort into two groups depending on the occurrence of early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of early mortality after TEER and further analyzed the risk factors associated with early mortality.</p><p><strong>Results: </strong>A total of 15,931 patients who had TEER were included; 292 (1.8 %) with early mortality and 15,639 (98.2 %) without. There was a decreasing trend in early mortality from 2.8 % in the first quarter of 2017 to 1.2 % in the fourth quarter of 2020, but it was not statistically significant (p = 0.18). In multivariable analysis, the independent risk factors for early mortality were chronic kidney disease not requiring dialysis (adjusted odds ratio [aOR]: 1.57; 95 % confidence interval [CI]: 1.11-2.22, p = 0.01), end-stage renal disease (aOR: 2.34; CI: 1.44-3.79, p < 0.01), chronic liver disease (aOR: 4.90; CI: 3.29-7.29, p < 0.01), coagulation disorder (aOR: 3.42; CI: 2.35-5.03, p < 0.01), systolic heart failure (aOR: 2.81; CI: 1.34-5.90, p < 0.01), diastolic heart failure (aOR: 2.69; CI: 1.24-5.84, p = 0.01) and unspecified heart failure (aOR: 3.23; CI: 1.49-7.01, p < 0.01). Among those who died during 30-day readmission following TEER, the most common cardiac cause and non-cardiac-cause of readmission were heart failure (18.2 %) and infection (26.6 %), respectively.</p><p><strong>Conclusion: </strong>The early mortality following TEER was low at 1.8 %. The independent risk factors associated with early mortality were chronic kidney disease (including end-stage renal disease), chronic liver disease, coagulation disorder, and heart failure (both systolic and diastolic).</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Revascularization Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.carrev.2024.08.001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: While transcatheter edge-to-edge repair (TEER) with MitraClip is increasingly used, data on the risk stratification for assessing early mortality after this procedure are scarce.

Objective: This study aimed to assess early mortality and analyze the risk factors of early mortality among patients who underwent TEER.

Methods: Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged 18 years or older who had TEER between January 2017 and November 2020. We categorized the cohort into two groups depending on the occurrence of early mortality (death within 30 days after the procedure). Based on the ICD-10, we identified the trend of early mortality after TEER and further analyzed the risk factors associated with early mortality.

Results: A total of 15,931 patients who had TEER were included; 292 (1.8 %) with early mortality and 15,639 (98.2 %) without. There was a decreasing trend in early mortality from 2.8 % in the first quarter of 2017 to 1.2 % in the fourth quarter of 2020, but it was not statistically significant (p = 0.18). In multivariable analysis, the independent risk factors for early mortality were chronic kidney disease not requiring dialysis (adjusted odds ratio [aOR]: 1.57; 95 % confidence interval [CI]: 1.11-2.22, p = 0.01), end-stage renal disease (aOR: 2.34; CI: 1.44-3.79, p < 0.01), chronic liver disease (aOR: 4.90; CI: 3.29-7.29, p < 0.01), coagulation disorder (aOR: 3.42; CI: 2.35-5.03, p < 0.01), systolic heart failure (aOR: 2.81; CI: 1.34-5.90, p < 0.01), diastolic heart failure (aOR: 2.69; CI: 1.24-5.84, p = 0.01) and unspecified heart failure (aOR: 3.23; CI: 1.49-7.01, p < 0.01). Among those who died during 30-day readmission following TEER, the most common cardiac cause and non-cardiac-cause of readmission were heart failure (18.2 %) and infection (26.6 %), respectively.

Conclusion: The early mortality following TEER was low at 1.8 %. The independent risk factors associated with early mortality were chronic kidney disease (including end-stage renal disease), chronic liver disease, coagulation disorder, and heart failure (both systolic and diastolic).

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
经导管边缘到边缘二尖瓣反流修复术后早期死亡率的风险因素。
背景:虽然使用MitraClip进行经导管边缘到边缘修补术(TEER)的患者越来越多,但评估该手术后早期死亡率的风险分层数据却很少:本研究旨在评估接受 TEER 患者的早期死亡率,并分析早期死亡率的风险因素:我们的研究使用了具有全国代表性的全国再入院数据库(Nationwide Readmissions Database),纳入了在 2017 年 1 月至 2020 年 11 月期间接受 TEER 的 18 岁或以上患者。我们根据早期死亡(术后 30 天内死亡)的发生率将队列分为两组。根据ICD-10,我们确定了TEER术后早期死亡的趋势,并进一步分析了与早期死亡相关的风险因素:共纳入 15,931 例 TEER 患者,其中 292 例(1.8%)有早期死亡,15,639 例(98.2%)无早期死亡。早期死亡率呈下降趋势,从2017年第一季度的2.8%降至2020年第四季度的1.2%,但无统计学意义(P = 0.18)。在多变量分析中,早期死亡的独立风险因素是不需要透析的慢性肾病(调整后的几率比 [aOR]:1.57; 95 % 置信区间 [CI]:1.11-2.22,P = 0.01)、终末期肾病(aOR:2.34;CI:1.44-3.79,P = 0.01)、急性肾衰竭(aOR:2.34;CI:1.44-3.79,P = 0.01TEER 的早期死亡率较低,仅为 1.8%。与早期死亡率相关的独立风险因素是慢性肾病(包括终末期肾病)、慢性肝病、凝血功能障碍和心力衰竭(收缩期和舒张期)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Cardiovascular Revascularization Medicine
Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
5.90%
发文量
687
审稿时长
36 days
期刊介绍: Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.
期刊最新文献
Left atrial appendage occlusion in patients with amyloidosis: a nationwide cohort analysis. Real-world outcomes and management considerations following surgical aortic valve replacement with the Trifecta valve. Trends in utilization and clinical outcomes with and without the use of distal filter wire embolic protection devices. Validation of the coronary artery specific chronic total occlusion percutaneous coronary intervention angiographic difficulty scores in the PROGRESS-CTO registry. Surviving venoarterial extracorporeal membrane oxygenation (VA-ECMO): The roles of severity scores and post-operative lactate clearance.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1