In-Hospital Mortality Trends and Association of Peripheral Artery Disease on Mortality Risk After Aortic Valve...

Area of Science:

• Cardiology
• Interventional Cardiology
• Health Services Research

Background:

• Transcatheter aortic valve replacement (TAVR) emerged as an alternative to surgical valve replacement (SAVR) in 2011.
• In-hospital mortality trends and predictors following SAVR and TAVR require ongoing investigation.
• The association between peripheral artery disease (PAD) and TAVR outcomes remains understudied.

Purpose of the Study:

• To analyze predictors and temporal trends of in-hospital mortality for SAVR and TAVR from 2011-2019.
• To evaluate the impact of peripheral artery disease (PAD) on mortality risk after TAVR.

Main Methods:

• Retrospective cohort analysis of the National Inpatient Sample database (2011-2019).
• Inclusion criteria: patients undergoing SAVR or TAVR for aortic stenosis.
• Primary outcome: in-hospital mortality. Statistical analysis included logistic regression and interaction terms for temporal trends.

Main Results:

• The study included 129,305 patients (63.9% SAVR, 36.1% TAVR).
• Key mortality predictors: age, elective status, and procedure type (TAVR OR=0.54).
• TAVR mortality risk was initially higher than SAVR (2011-2014) but decreased significantly post-2014, falling below SAVR levels. PAD was not a significant predictor of TAVR mortality.

Conclusions:

• TAVR demonstrated a significant decrease in mortality risk over time, surpassing SAVR in later years.
• Peripheral artery disease (PAD) was not found to be a significant predictor of in-hospital mortality in patients undergoing TAVR.