Simultaneous Estimation of Gender Male and Atrial Fibrillation as Risk Factors for Adverse Outcomes Following Transcatheter Aortic Valve Implantation.
Simultaneous Estimation of Gender Male and Atrial Fibrillation as Risk Factors for Adverse Outcomes Following Transcatheter Aortic Valve Implantation.
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DOI：
10.3390/jcm9123963
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发表时间：
2020-12-07
影响因子：
3.9
通讯作者：
Minamino T
中科院分区：
文献类型：
--
作者：
Chikata Y;Iwata H;Doi S;Funamizu T;Okazaki S;Dohi S;Higuchi R;Saji M;Takamisawa I;Tamura H;Amano A;Daida H;Minamino T
随着经导管主动脉瓣植入术（TAVI）适应症扩展至手术风险较低的患者，TAVI后准确的结局预测沿着变得更加重要。尽管先前的研究已经评估了性别和房颤（AF）对TAVI患者预后的影响，但这两个因素很少同时得到解决。这项基于多中心TAVI登记研究的回顾性观察性研究涉及2010年5月至2020年2月在日本3家医院接受TAVI的1088例患者。受试者按性别和既往AF分为4组，如女性AF（-）（n = 559）、男性AF（-）（n = 266）、女性AF（+）（n = 187）和男性AF（+）（n = 76）。主要和次要终点分别为任何原因和心血管原因导致的死亡，以及全因死亡和心力衰竭住院的复合终点。中位随访期为538天。女性AF（−）组的主要和次要终点的累积发生率低于其他3组。调整后的多变量考克斯比例风险分析显示，与无上述因素的组相比，男性和AF中的一个或两个与不良结局独立相关（风险比和95%置信区间与女性AF（−））（参考）男性AF（−）的全因死亡：2.7，1.6-4.6，p < 0.001，女性AF（+）：3.5，2.1-6.0，p < 0.001，男性AF（+）：3.9，1.9-7.8，p < 0.001），而没有证据表明它们具有协同预后影响。男性性别和AF并发症独立（但非协同）预测接受TAVI患者的长期结局不佳。
Accurate outcome prediction following transcatheter aortic valve implantation (TAVI) has gained further importance along with expanding its indication to patients with a lower surgical risk. Although previous studies have evaluated the prognostic impacts of gender and atrial fibrillation (AF) in TAVI patients, these two factors have rarely been addressed simultaneously. This retrospective observational study based on a multicenter TAVI registry involved 1088 patients who underwent TAVI between May, 2010 and February, 2020 at 3 hospitals in Japan. Participants were divided into 4 groups by gender and pre-existing AF, such as Female AF (−) (n = 559), Male AF (−) (n = 266), Female AF (+) (n = 187) and Male AF (+) (n = 76). Primary and secondary endpoints were death due to any and cardiovascular cause, and the composite of all-cause death and heart failure hospitalization, respectively. The median follow-up period was 538 days. Cumulative incidences of primary and secondary endpoints were lower in the Female AF (−) group compared to the other 3 groups. Adjusted multivariate Cox proportional hazard analyses showed an independent association of either or both of male gender and AF with adverse outcomes, when compared to the group with none of these (hazard ratios and 95% confidence intervals vs. Female AF (−) (reference) for all-cause death of Male AF (−): 2.7, 1.6–4.6, p < 0.001, Female AF (+): 3.5, 2.1–6.0, p < 0.001, and Male AF (+): 3.9, 1.9–7.8, p < 0.001), while there was no evidence of their synergistic prognostic impact. Male gender and being complicated by AF independently, but not synergistically, predicted poor long-term outcomes in patients undergoing TAVI.
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影响因子：
11.3
作者：
Chopard, Romain;Teiger, Emmanuel;Schiele, Francois
通讯作者：
Schiele, Francois
影响因子：
24
作者：
Hayashida, Kentaro;Morice, Marie-Claude;Lefevre, Thierry
通讯作者：
Lefevre, Thierry
影响因子：
24
作者：
Nguyen, Virginia;Michel, Morgane;Messika-Zeitoun, David
通讯作者：
Messika-Zeitoun, David
影响因子：
24
作者：
Auffret, Vincent;Lefevre, Thierry;Le Breton, Herve
通讯作者：
Le Breton, Herve
影响因子：
24
作者：
Holmes, David R., Jr.;Mack, Michael J.;Thomas, James D.
通讯作者：
Thomas, James D.