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Simultaneous Estimation of Gender Male and Atrial Fibrillation as Risk Factors for Adverse Outcomes Following Transcatheter Aortic Valve Implantation
- Source :
- Journal of Clinical Medicine, Vol 9, Iss 3963, p 3963 (2020), Journal of Clinical Medicine, Volume 9, Issue 12
- Publication Year :
- 2020
- Publisher :
- MDPI AG, 2020.
-
Abstract
- 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&ndash<br />4.6, p &lt<br />0.001, Female AF(+): 3.5, 2.1&ndash<br />6.0, p &lt<br />0.001, and Male AF(+): 3.9, 1.9&ndash<br />7.8, p &lt<br />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.
- Subjects :
- long-term outcome
medicine.medical_specialty
Transcatheter aortic
Adverse outcomes
lcsh:Medicine
030204 cardiovascular system & hematology
Article
TAVI
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
In patient
030212 general & internal medicine
business.industry
Hazard ratio
lcsh:R
Atrial fibrillation
Retrospective cohort study
General Medicine
AF
medicine.disease
Confidence interval
Heart failure
gender difference
Cardiology
business
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Volume :
- 9
- Issue :
- 3963
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....f9950aaa3fd07e88f30c17a7cebbcc64