Transcatheter Aortic Valve Replacement in Patients With or Without Active Cancer

Area of Science:

• Cardiology
• Oncology
• Health Services Research

Background:

• Clinical outcomes data for transcatheter aortic valve replacement (TAVR) in patients with active cancer or metastatic disease are limited.
• Understanding these outcomes is crucial for optimizing patient care and decision-making.

Purpose of the Study:

• To investigate the impact of active cancer on short-term mortality, complications, and readmission rates following TAVR.
• To analyze these outcomes across various cancer types.

Main Methods:

• Utilized the Nationwide Readmissions Database (2012-2019) for TAVR cases.
• Stratified patients by specific cancer types and analyzed in-hospital mortality, bleeding requiring transfusion, and 30/90/180-day readmissions.
• Adjusted for potential confounding factors.

Main Results:

• Active cancer was not associated with increased in-hospital mortality (aOR 1.06).
• Active cancer patients had higher risks of 30, 90, and 180-day readmissions and 30-day bleeding requiring transfusion.
• Colon, prostate, and metastatic cancers were independently linked to increased bleeding risk; colon and metastatic cancers were linked to higher readmission rates.

Conclusions:

• Patients with active cancer undergoing TAVR have comparable in-hospital mortality rates to those without cancer.
• Active cancer is associated with significantly higher risks of post-TAVR readmission and bleeding requiring transfusion, with specific cancer types posing greater risks.