临床结局 超大致阻塞性心肌病症患者的传导管后大动脉置换
Muhammad Usman Almani1, Vibhor Ahluwalia2, Muhammad Yousuf3
1Division of Cardiology, Jefferson Einstein Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
概括
在患有高阻塞性心肌病 (HOCM) 的患者中,透管大动脉置换 (TAVR) 与住院死亡风险显著增加有关. 然而,TAVR后的HOCM和非HOCM患者的再接收结果相似.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 从历史上看,高压阻塞性心肌病 (HOCM) 患者被排除在过导管大动脉置换 (TAVR) 试验之外.
- 在TAVR后",左心室自杀"是由于左心室外流通道阻塞的潜在恶化而引起的担忧.
研究的目的:
- 评估接受TAVR的HOCM患者的临床和再接收结果.
- 为了比较TAVR患者与并发性HOCM之间的结果.
主要方法:
- 利用来自国家住院患者和国家再接收数据库 (2016-2020) 的数据.
- 对住院死亡率和临床结果进行了多变量逻辑回归.
- 用多变量考克斯回归进行30天再接收评估.
主要成果:
- 在296,670例TAVR病例中,确定了534名HOCM患者 (0.2%).
- HOCM患者在住院死亡的风险增加了超过3倍 (aOR: 3.47).
- 在HOCM患者中,心房阻塞,心脏性休克,急性损伤和输管治疗的发生率较高;再入院的发生率没有差异.
结论:
- 在HOCM患者中TAVR与显著更高的住院死亡率有关.
- 患有HOCM的患者在TAVR期间面临更多的程序并发症.
- 现实世界的数据表明,接受TAVR的HOCM患者的风险增加.
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