Causes and predictors of readmission after transcatheter aortic valve implantation

Li, Yiming; Mei, Fuyang; Yao, Yijun; Tsauo, Jia-Yu; Peng, Yong; Chen, Mao

doi:10.1007/s00059-019-04870-6

Cited by 16 publications

(26 citation statements)

References 51 publications

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“…HF was most common as main diagnosis, accounting for 16% of the total hospitalizations and half of cardiovascular hospitalizations. The numbers are consistent with earlier studies on both short-term and long-term hospitalization 9 , 16 and suggest that HF represent an important cause of disability after TAVI.…”

Section: Discussionsupporting

confidence: 91%

“…ACS/angina pectoris accounted for a higher number than in previous studies where levels around a few percent are reported. 9 , 16 A plausible explanation might be that in the previous studies, only ACS is accounted for and if stable angina pectoris is added, the numbers might be more similar. Furthermore, since many previous studies only register the first hospitalization, they do not have the possibility to find patients with repeated hospitalizations due to both HF and ACS/angina pectoris which might affect the proportions.…”

Section: Discussionmentioning

confidence: 98%

“…Readmission rates are considered important markers of both clinical outcome and cost-effectiveness. 9 However, earlier studies on readmission rates after TAVI focus on time to event only ignoring repeated events. 9 The Swedish registries, 10 , 11 with nationwide complete coverage of deaths and hospitalizations over time offers a unique possibility to study the total burden of hospitalizations, hospitalization characteristics, and predictors of multiple admissions in a real-life setting.…”

Section: Introductionmentioning

confidence: 99%

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Causes, pattern, predictors, and prognostic implications of new hospitalizations after transcatheter aortic valve implantation: a long-term nationwide observational study

Nilsson

Buccheri

Christersson

et al. 2021

European Heart Journal - Quality of Care and Clinical Outcomes

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Aim The aim of this study was to investigate the pattern, causes and predictors of all new hospitalizations in patients who underwent TAVI. Methods and results The nationwide Swedish TAVI-registry was merged with other mandatory health care registries, which enabled the analysis of all TAVI-procedures, new hospital admissions and death between the years 2008 and 2017. A total of 2821 patients underwent TAVI with a mean of 2.5 hospitalizations during a mean Follow-up of 2.2 years. Hospitalizations were associated with worse prognosis. Heart failure (HF) was the most common cause of hospitalization with 19% having at least one hospitalization due to HF causing 16% of all-cause admissions and 50% of cardiovascular admissions. Male gender, age > 90 years, high Charlson Comorbidity Index, atrial fibrillation, present neurologic disease, severe renal impairment, peripheral vascular disease, New York Heart Association class IV, mild or moderate mean aortic valve gradients and pulmonary hypertension were associated with an increased risk for all-cause hospitalizations or death. For cardiovascular hospitalization or death, the pattern was similar, with the addition of impaired systolic left ventricular function as a predictor. Conclusion Multiple hospitalizations after TAVI are common, and are often caused by HF. Reducing the rate of HF hospitalizations is important to mitigate the burden on the health care system due to new hospitalizations after TAVI.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Causes, pattern, predictors, and prognostic implications of new hospitalizations after transcatheter aortic valve implantation: a long-term nationwide observational study

Nilsson

Buccheri

Christersson

et al. 2021

European Heart Journal - Quality of Care and Clinical Outcomes

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“…Patients undergoing SVR or TAVR may present with several cardiovascular risk factors that can affect clinical outcome after the procedure [59]. In addition, co-existing adverse cardiac remodeling, PH and heart failure (HF) continue to have a strong impact on the clinical status, quality of life and survival of patients after successful TAVR [60,61]. Therefore, new-onset atrial fibrillation, TIA/stroke, myocardial infarction, acute kidney injury, severe bleeding and advanced HF were found to be strong predictors of poor clinical outcomes and higher rates of re-admission after TAVR even in AS patients with moderate risks [62,63].…”

Section: Biomarkersmentioning

confidence: 99%

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

Boxhammer

Berezin

Paar

et al. 2022

JPM

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Patients with severe aortic valve stenosis and concomitant pulmonary hypertension show a significantly reduced survival prognosis. Right heart catheterization as a preoperative diagnostic tool to determine pulmonary hypertension has been largely abandoned in recent years in favor of echocardiographic criteria. Clinically, determination of echocardiographically estimated systolic pulmonary artery pressure falls far short of invasive right heart catheterization data in terms of accuracy. The aim of the present systematic review was to highlight noninvasive possibilities for the detection of pulmonary hypertension in patients with severe aortic valve stenosis, with a special focus on cardiovascular biomarkers. A total of 525 publications regarding echocardiography, cardiovascular imaging and biomarkers related to severe aortic valve stenosis and pulmonary hypertension were analyzed in a systematic database analysis using PubMed Central®. Finally, 39 publications were included in the following review. It was shown that the current scientific data situation, especially regarding cardiovascular biomarkers as non-invasive diagnostic tools for the determination of pulmonary hypertension in severe aortic valve stenosis patients, is poor. Thus, there is a great scientific potential to combine different biomarkers (biomarker scores) in a non-invasive way to determine the presence or absence of PH.

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“…A majority of patients continue to present left ventricular hypertrophy even after SAVR or TAVI, who had a high risk for mortality and heart failure re-admission [4]. A previous meta-analysis found that the 30-day and 1-year incidence of re-admission following TAVI was 15% and 31%, respectively, of which nearly half resulted from the cardiac cause [5]. Compared with that of SAVR, TAVI is associated with a high risk for paravalvular leakage, even in patients with a new-generation transcatheter heart valve.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Angiotensin-converting enzyme inhibitor for post-transcatheter aortic valve implantation patients: study protocol for a multicenter randomized, open-label blinded endpoint control trial

Liao

Xia

Cheng

et al. 2021

Trials

Self Cite

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Background With the expanded utilization of transcatheter aortic valve implantation (TAVI) to younger and lower surgical risk patients with severe aortic stenosis (AS), optimal medical therapy after TAVI procedure has become the main concern. Renin-angiotensin system inhibitors (RASi) are widely utilized in the area of cardiovascular disease including heart failure and myocardial infarction and revealed the ability to reverse left ventricular (LV) remodeling. Interests have, thus, been drawn in investigating whether the prescription of RASi after the TAVI procedure can prevent or reverse cardiac remodeling and improve long-term clinical outcomes. No recommendation regarding the prescription of RASi after TAVI is proposed yet due to the lack of evidence from randomized controlled trials, especially in the Chinese population. We, therefore, designed this randomized controlled trial to explore the effect of adding fosinopril to standard care in patients who underwent a successful TAVI procedure on the LV remodeling. Methods A total of 200 post-TAVI patients from seven academic hospitals across China will be recruited and randomized with a ratio of 1:1 to receive standard care or standard care plus fosinopril. Follow-up visits will take place at 30 days, 3 months, 6 months, 12 months, and 24 months from randomization to assess the clinical symptoms, any adverse events, cardiac function, and quality of life. Cardiac magnetic resonance will be performed at baseline and repeated at the 24-month follow-up visit to assess LV remodeling. Discussion This study will provide evidence regarding medical therapy for AS patients who underwent TAVI and filling the gap in the Chinese population. Trial registration Chinese Clinical Trial Registry ChiCTR2100042266. Registered on 17 January 2021

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Causes and predictors of readmission after transcatheter aortic valve implantation

Cited by 16 publications

References 51 publications

Causes, pattern, predictors, and prognostic implications of new hospitalizations after transcatheter aortic valve implantation: a long-term nationwide observational study

Causes, pattern, predictors, and prognostic implications of new hospitalizations after transcatheter aortic valve implantation: a long-term nationwide observational study

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

Angiotensin-converting enzyme inhibitor for post-transcatheter aortic valve implantation patients: study protocol for a multicenter randomized, open-label blinded endpoint control trial

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