Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis

Michał Walczewski; Aleksandra Gąsecka; Adam Witkowski; Maciej Dabrowski; Zenon Huczek; Radosław Wilimski; Andrzej Ochała; Radosław Parma; Bartosz Rymuza; Marek Grygier; Marek Jemielity; Anna Olasińska-Wiśniewska; Dariusz Jagielak; Radosław Targoński; Krzysztof Pastuszak; Peter Grešner; Marcin Grabowski; Janusz Kochman

doi:10.5114/aic.2023.131478

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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abstract:

Original paper

Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis

Michał Walczewski

¹

,

Aleksandra Gąsecka

¹

,

Adam Witkowski

²

,

Maciej Dabrowski

²

,

Zenon Huczek

¹

,

Radosław Wilimski

¹

,

Andrzej Ochała

³

,

Radosław Parma

³

,

Bartosz Rymuza

¹

,

Marek Grygier

⁴

,

Marek Jemielity

⁵

,

Anna Olasińska-Wiśniewska

⁵

,

Dariusz Jagielak

⁶

,

Radosław Targoński

⁶

,

Krzysztof Pastuszak

^{7, 8, 9}

,

Peter Grešner

^{8, 9}

,

Marcin Grabowski

¹

,

Janusz Kochman

¹

1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
Chair and 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland
Department Algorithms and System Modeling, Technical University of Gdansk, Gdansk, Poland
Department of Translational Oncology, Medical University of Gdansk, Gdansk, Poland
Centre of Biostatistics and Bioinformatics Analysis, Medical University of Gdansk, Gdansk, Poland

Adv Interv Cardiol 2023; 19, 3 (73): 251–256

DOI: https://doi.org/10.5114/aic.2023.131478

Online publish date: 2023/09/27

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AMA

Walczewski M, Gąsecka A, Witkowski A, et al. Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2023;19(3):251-256. doi:10.5114/aic.2023.131478.

APA

Walczewski, M., Gąsecka, A., Witkowski, A., Dabrowski, M., Huczek, Z.,  & Wilimski, R. et al. (2023). Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 19(3), 251-256. https://doi.org/10.5114/aic.2023.131478

Chicago

Walczewski, Michał, Aleksandra Gąsecka, Adam Witkowski, Maciej Dabrowski, Zenon Huczek, Radosław Wilimski,  and Andrzej Ochała et al. 2023. "Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 19 (3): 251-256. doi:10.5114/aic.2023.131478.

Harvard

Walczewski, M., Gąsecka, A., Witkowski, A., Dabrowski, M., Huczek, Z., Wilimski, R., Ochała, A., Parma, R., Rymuza, B., Grygier, M., Jemielity, M., Olasińska-Wiśniewska, A., Jagielak, D., Targoński, R., Pastuszak, K., Grešner, P., Grabowski, M.,  and Kochman, J. (2023). Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 19(3), pp.251-256. https://doi.org/10.5114/aic.2023.131478

MLA

Walczewski, Michał et al. "Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 19, no. 3, 2023, pp. 251-256. doi:10.5114/aic.2023.131478.

Vancouver

Walczewski M, Gąsecka A, Witkowski A, Dabrowski M, Huczek Z, Wilimski R et al. Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2023;19(3):251-256. doi:10.5114/aic.2023.131478.

Introduction:
Data regarding patients with a previous medical record of immunosuppression treatment who have undergone transcatheter aortic valve implantation (TAVI) are limited and extremely inconclusive. Available studies are mostly short term observations; thus there is a lack of evidence on efficacy and safety of TAVI in this specific group of patients.

Aim:
To compare the in-hospital and long-term outcomes between patients with or without a medical history of immunosuppressive treatment undergoing TAVI for aortic valve stenosis (AS).

Material and methods:
We conducted a retrospective registry-based analysis including patients undergoing TAVI for AS at 5 centres between January 2009 and August 2017. The primary endpoint was long-term all-cause mortality. Secondary endpoints comprised major vascular complications, life-threatening or disabling bleeding, stroke and new pacemaker implantation.

Results:
Of 1451 consecutive patients who underwent TAVI, two propensity-matched groups including 25 patients with a history of immunosuppression and 75 patients without it were analysed. No differences between groups in all-cause mortality were found in a median follow-up time of 2.7 years following TAVI (p = 0.465; HR = 0.73; 95% CI: 0.30–1.77). The rate of major vascular complications (4.0% vs. 5.3%) was similar in the two groups (p = 1.000). There were no statistically significant differences in the composite endpoint combining life-threatening or disabling bleeding, major vascular complications, stroke and new pacemaker implantation (40.0% vs. 20.0%, p = 0.218).

Conclusions:
Patients who had undergone TAVI for AS had similar long-term mortality regardless of whether they had a previous medical record of immunosuppression. Procedural complication rates were comparable between the groups.

keywords:

Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis

aortic stenosis, immunosuppression, mortality, outcomes, transcatheter aortic valve implantation