Transcatheter Aortic Valve Replacement Outcomes in End-Stage Renal Disease Patients on Hemodialysis Requiring Midodrine.
End stage renal disease
Midodrine
Survival
Transcatheter aortic valve replacement
Journal
Structural heart : the journal of the Heart Team
ISSN: 2474-8714
Titre abrégé: Struct Heart
Pays: United States
ID NLM: 101743256
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
28
07
2022
revised:
04
01
2023
accepted:
18
01
2023
medline:
5
6
2023
pubmed:
5
6
2023
entrez:
5
6
2023
Statut:
epublish
Résumé
Patients with dialysis-dependent end-stage renal disease (ESRD) taking midodrine may be at high risk for poor outcomes following transcatheter aortic valve replacement (TAVR). We evaluated dialysis-dependent ESRD patients taking midodrine. We conducted a retrospective analysis of non-clinical trial TAVR patients from February 2012 to December 2020 from 11 facilities in a Western US health system. Patient groups included ESRD patients on midodrine before TAVR (ESRD [+M]), ESRD patients without midodrine (ESRD [-M]), and non-ESRD patients. The endpoints of 30-day and 1-year mortality were represented by Kaplan-Meier survival estimator and compared by log-rank test. Forty-five ESRD (+M), 216 ESRD (-M), and 6898 non-ESRD patients were included. ESRD patients had more comorbid conditions, despite no significant difference in predicted Society of Thoracic Surgeons mortality risk between ESRD (+M) and ESRD (-M) (8.7% vs. 9.2%, Our experience suggests ESRD patients on midodrine are a higher acuity population with worse survival after TAVR, compared to ESRD patients not on midodrine. These findings may help with risk stratification for ESRD patients undergoing TAVR.
Sections du résumé
Background
UNASSIGNED
Patients with dialysis-dependent end-stage renal disease (ESRD) taking midodrine may be at high risk for poor outcomes following transcatheter aortic valve replacement (TAVR). We evaluated dialysis-dependent ESRD patients taking midodrine.
Methods
UNASSIGNED
We conducted a retrospective analysis of non-clinical trial TAVR patients from February 2012 to December 2020 from 11 facilities in a Western US health system. Patient groups included ESRD patients on midodrine before TAVR (ESRD [+M]), ESRD patients without midodrine (ESRD [-M]), and non-ESRD patients. The endpoints of 30-day and 1-year mortality were represented by Kaplan-Meier survival estimator and compared by log-rank test.
Results
UNASSIGNED
Forty-five ESRD (+M), 216 ESRD (-M), and 6898 non-ESRD patients were included. ESRD patients had more comorbid conditions, despite no significant difference in predicted Society of Thoracic Surgeons mortality risk between ESRD (+M) and ESRD (-M) (8.7% vs. 9.2%,
Conclusions
UNASSIGNED
Our experience suggests ESRD patients on midodrine are a higher acuity population with worse survival after TAVR, compared to ESRD patients not on midodrine. These findings may help with risk stratification for ESRD patients undergoing TAVR.
Identifiants
pubmed: 37273855
doi: 10.1016/j.shj.2023.100163
pii: S2474-8706(23)00010-6
pmc: PMC10236793
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100163Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
E. C. Korngold: Abbott Vascular: Consulting, honoraria; Boston Scientific: Consulting, honoraria; Edwards Lifesciences: Consulting, honoraria, proctoring; Medtronic: Consulting, honoraria; RJ, none; KJS, none; VK, none; BC, Abbott Vascular: Consulting; SG, Edwards Lifesciences: consultant; DP, none; DS: none; AR: none; LM: none; BJ, none. The other authors had no conflicts to declare.
Références
J Am Coll Cardiol. 2018 Mar 27;71(12):1297-1308
pubmed: 29566812
JACC Cardiovasc Interv. 2017 Oct 23;10(20):2050-2060
pubmed: 29050621
J Am Coll Cardiol. 2008 Apr 15;51(15):1466-72
pubmed: 18402902
Circulation. 2013 Jun 11;127(23):2316-26
pubmed: 23661722
Heart. 2005 Oct;91(10):1324-9
pubmed: 16162627
Stat Med. 2002 Apr 30;21(8):1129-44
pubmed: 11933038
Clin Transplant. 2018 Sep;32(9):e13366
pubmed: 30076650
Eur Heart J. 2014 Oct 7;35(38):2685-96
pubmed: 24796337
J Am Coll Cardiol. 2019 Jun 11;73(22):2806-2815
pubmed: 31171086
Clin Nephrol. 1998 Aug;50(2):101-7
pubmed: 9725781
EuroIntervention. 2014 Nov;10(7):850-9
pubmed: 25415152