Subtype of atrial fibrillation and the outcome of transcatheter aortic valve replacement: The FinnValve Study.
Aged
Aged, 80 and over
Aortic Valve Stenosis
/ complications
Atrial Fibrillation
/ classification
Cohort Studies
Female
Finland
/ epidemiology
Heart Valve Prosthesis Implantation
/ adverse effects
Humans
Kaplan-Meier Estimate
Male
Postoperative Complications
/ etiology
Prognosis
Registries
Retrospective Studies
Risk Factors
Stroke
/ etiology
Transcatheter Aortic Valve Replacement
/ adverse effects
Treatment Outcome
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
11
06
2020
accepted:
26
08
2020
entrez:
11
9
2020
pubmed:
12
9
2020
medline:
3
11
2020
Statut:
epublish
Résumé
Whether the subtype of atrial fibrillation affects outcomes after transcatheter aortic valve replacement for aortic stenosis is unclear. The nationwide FinnValve registry included 2130 patients who underwent primary after transcatheter aortic valve replacement for aortic stenosis during 2008-2017. Altogether, 281 (13.2%) patients had pre-existing paroxysmal atrial fibrillation, 651 (30.6%) had pre-existing non-paroxysmal atrial fibrillation and 160 (7.5%) were diagnosed with new-onset atrial fibrillation during the index hospitalization. The median follow-up was 2.4 (interquartile range: 1.6-3.8) years. Paroxysmal atrial fibrillation did not affect 30-day or overall mortality (p-values >0.05). Non-paroxysmal atrial fibrillation demonstrated an increased risk of overall mortality (hazard ratio: 1.61, 95% confidence interval: 1.35-1.92; p<0.001), but not 30-day mortality (p = 0.084). New-onset atrial fibrillation demonstrated significantly increased 30-day mortality (hazard ratio: 2.76, 95% confidence interval: 1.25-6.09; p = 0.010) and overall mortality (hazard ratio: 1.68, 95% confidence interval: 1.29-2.19; p<0.001). The incidence of early or late stroke did not differ between atrial fibrillation subtypes (p-values >0.05). In conclusion, non-paroxysmal atrial fibrillation and new-onset atrial fibrillation are associated with increased mortality after transcatheter aortic valve replacement for aortic stenosis, whereas paroxysmal atrial fibrillation has no effect on mortality. These findings suggest that non-paroxysmal atrial fibrillation rather than paroxysmal atrial fibrillation may be associated with structural cardiac damage which is of prognostic significance in patients with aortic stenosis undergoing transcatheter aortic valve replacement.
Identifiants
pubmed: 32915895
doi: 10.1371/journal.pone.0238953
pii: PONE-D-20-17891
pmc: PMC7485765
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0238953Déclaration de conflit d'intérêts
I have read the journal's policy and the authors of this manuscript have the following competing interests: Dr. Mikko Savontaus is proctor for Medtronic and Dr. Mika Laine is proctor for Boston Scientific. The other coauthors do not have any conflict of interest related to this study. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Références
Lancet. 1999 Jan 16;353(9148):205-6
pubmed: 9923878
Eur J Cardiothorac Surg. 2012 Apr;41(4):734-44; discussion 744-5
pubmed: 22378855
BMC Cardiovasc Disord. 2005 Jul 11;5:20
pubmed: 16008832
Eur Heart J. 2017 May 1;38(17):1285-1293
pubmed: 27744287
Nat Rev Cardiol. 2019 Jul;16(7):417-436
pubmed: 30792496
Cardiovasc Ultrasound. 2012 Sep 25;10:38
pubmed: 23006976
Eur Heart J. 2017 Sep 21;38(36):2739-2791
pubmed: 28886619
J Am Coll Cardiol. 2012 Oct 9;60(15):1438-54
pubmed: 23036636
Ann Med. 2019 May - Jun;51(3-4):270-279
pubmed: 31112060
Am J Cardiol. 2018 Oct 1;122(7):1215-1221
pubmed: 30089530
JACC Cardiovasc Interv. 2016 May 9;9(9):937-46
pubmed: 27085579
Radiology. 2019 Sep;292(3):575-582
pubmed: 31310173
JACC Cardiovasc Interv. 2019 Nov 11;12(21):2119-2129
pubmed: 31629743
N Engl J Med. 2020 Apr 30;382(18):1696-1707
pubmed: 32223116
EuroIntervention. 2015 Jun;11(2):214-20
pubmed: 26093840
Circ Arrhythm Electrophysiol. 2017 Jan;10(1):
pubmed: 28077507
J Am Coll Cardiol. 2017 Jul 11;70(2):252-289
pubmed: 28315732
Circulation. 1998 Sep 8;98(10):946-52
pubmed: 9737513
J Thorac Cardiovasc Surg. 2006 Jun;131(6):1364-72
pubmed: 16733171
Heart Lung Circ. 2020 May;29(5):748-758
pubmed: 31278056
Eur Heart J. 2007 Oct;28(19):2346-53
pubmed: 17670754
Open Heart. 2018 Jan 20;5(1):e000695
pubmed: 29387427
Circ Cardiovasc Interv. 2013 Feb;6(1):77-84
pubmed: 23386662
J Thromb Thrombolysis. 2019 Feb;47(2):174-178
pubmed: 30484011
Eur Heart J. 2017 Dec 1;38(45):3351-3358
pubmed: 29020232
EuroIntervention. 2016 Oct 10;12(8):e1047-e1056
pubmed: 26610809
JACC Cardiovasc Interv. 2018 Sep 10;11(17):1746-1756
pubmed: 30190063
Am J Med. 2002 Oct 1;113(5):359-64
pubmed: 12401529
Stroke. 1991 Aug;22(8):983-8
pubmed: 1866765
Am Heart J. 2018 Jun;200:44-50
pubmed: 29898848
Am Heart J. 2017 Oct;192:64-75
pubmed: 28938965
J Am Coll Cardiol. 2014 Apr 22;63(15):1510-9
pubmed: 24486264
Int J Cardiol. 2016 Jan 15;203:264-6
pubmed: 26519681