Impact of Baseline Atrial Fibrillation on Outcomes Among Women Who Underwent Contemporary Transcatheter Aortic Valve Implantation (from the Win-TAVI Registry) - 13/11/18

Doi : 10.1016/j.amjcard.2018.08.036

Paul Guedeney, MD ^a,^b,^{⁎
Paul Guedeney, Alaide Chieffo, and Clayton Snyder equally contributed to the manuscript.}, Alaide Chieffo, MD ^c,^{⁎
Paul Guedeney, Alaide Chieffo, and Clayton Snyder equally contributed to the manuscript.}, Clayton Snyder, BSc ^a,^{⁎
Paul Guedeney, Alaide Chieffo, and Clayton Snyder equally contributed to the manuscript.}, Julinda Mehilli, MD ^d, Anna Sonia Petronio, MD ^e, Bimmer E. Claessen, MD, PhD ^a, Samantha Sartori, PhD ^a, Thierry Lefèvre, MD ^f, Patrizia Presbitero, MD ^g, Piera Capranzano, MD ^h, Didier Tchétché, MD ⁱ, Alessandro Iadanza, MD ^j, Gennaro Sardella, MD ^k, Nicolas M. Van Mieghem, MD, PhD ^l, Jaya Chandrasekhar, MD, MS ^a, Birgit Vogel, MD ^a, Sabato Sorrentino, MD, PhD ^a, Deborah N. Kalkman, MD, PhD ^a, Emanuele Meliga, MD ^m, Nicolas Dumonteil, MD ⁿ, Chiara Fraccaro, MD, PhD ^o, Daniela Trabattoni, MD ^p, Ghada Mikhail, MD ^q, Maria Cruz Ferrer, MD ^r, Christoph Naber, MD ^s, Peter Kievit, MD ^t, Usman Baber, MD, MSc ^a, Samin Sharma, MD ^u, Marie Claude Morice, MD ^f, Roxana Mehran, MD ^a,^⁎
WIN-TAVI Investigators
^a Icahn School of Medicine at Mount Sinai, New York City, New York
^b ACTION Study Group, Sorbonne Université, Institut de Cardiologie, Département de Cardiologie, Pitié Salpêtrière Hospital (AP-HP), Paris, France
^c San Raffaele Scientific Institute, Milan, Italy
^d Munich University Clinic, Ludwig-Maximilians-University and German Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
^e AOUP Cisanello, University Hospital, Pisa, Italy
^f Institut Hospitalier Jacques Cartier, Ramsay Générale de Santé, Massy, France
^g Istituto Clinico Humanitas, Milan, Italy
^h University of Catania, Catania, Italy
ⁱ Clinique Pasteur, Toulouse, France
^j Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Siena, Italy
^k Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy
^l Erasmus Medical Center, Thorax center, Rotterdam, The Netherlands
^m Mauriziano Hospital, Turin, Italy
ⁿ Rangueil University Hospital, Toulouse, France
^o University of Padova, Padova, Italy
^p Centro Cardiologico Monzino, Milan, Italy
^q Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
^r Hospital Universitario Miguel Servet, Zaragoza, Spain
^s Contilia Heart and Vascular Centre, Elisabeth Krankenhaus, Essen, Germany
^t Department of Cardiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
^u Mount Sinai Hospital, New York City, New York

^⁎⁎Corresponding author: Tel: +1 212-241-7014; fax: +1 212-241-0273.

Résumé

Pre-existing atrial fibrillation (AF) is common among patients who underwent transcatheter aortic valve implantation (TAVI) and has been associated with adverse outcomes. The specific impact of AF at baseline in women who underwent TAVI, however, remains unknown. The Women's International Transcatheter Aortic Valve Implantation is a prospective, multinational registry evaluating the safety and performance of contemporary TAVI in women in 19 centers between January 2013 and December 2015. Patients with available electrocardiogram at baseline were compared according to the presence of AF. All events were adjudicated according to the Valve Academic Research Consortium 2 criteria. Associations between AF and outcomes were tested using multivariate Cox regression model. Of the 993 women with available baseline electrocardiogram included in the study, 200 (20.1%) presented with AF. Patients with AF at baseline had higher Euroscore I score values and more frequently had chronic kidney disease or prior stroke. Patients without AF more frequently had coronary artery disease. There was no difference regarding in-hospital events between the two groups aside from longer length of stay for patients with AF (13.3 ± 11 vs 11.5 ± 7.1 days, p = 0.01). In multivariate analysis, AF at baseline was associated with an increase of all-cause and cardiovascular death at 12 months (_adjHR 1.67 95%CI 1.11 to 2.50, p = 0.013 and _adjHR 1.85 95%CI 1.19 to 2.86, p = 0.006 respectively). In conclusion, in this prospective registry of women who underwent contemporary TAVI, the presence of AF at baseline was associated with significantly increased 12-month mortality.

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Vol 122 - N° 11

P. 1909-1916 - décembre 2018 Retour au numéro

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Impact of Baseline Atrial Fibrillation on Outcomes Among Women Who Underwent Contemporary Transcatheter Aortic Valve Implantation (from the Win-TAVI Registry) - 13/11/18

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