Future cardiology · 2024
Temporal trends and procedural safety of mitral valve transcatheter edge to edge repair in patients with previous CABG.
СтатьяНазвание и аннотация: Перевод в очереди
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Ahmed Asmaa, Eisa Mahmoud, Takla Andrew, Arora Sahej, Mohamed Mohamed Salah, Hanafi Amir, Feitell Scott
Аннотация
INTRODUCTION: Mitral Valve Transcatheter Edge-to-Edge Repair (M-TEER) is a minimally invasive procedure for patients with symptomatic mitral regurgitation. Its outcomes in patients with a history of coronary artery bypass grafting (CABG) remain unclear.
METHODOLOGY: We analyzed data from the Nationwide Inpatient Sample, using ICD-10-CM codes for M-TEER and CABG. Primary outcomes included in-hospital all-cause mortality and periprocedural cardiac complications. Inverse probability of treatment weighting was employed to compare M-TEER patients with or without prior CABG.
RESULTS: From January 2016 to December 2020, we identified 48,835 M-TEER cases in the U.S. with 9,655 patients (19.78%) having a prior CABG. These patients were older and had more comorbidities. M-TEER procedures increased over the study period, including those with prior CABG (2,145 in 2016 vs. 2,682 in 2020). Adjusted analysis showed no significant difference in in-hospital mortality between patients with and without prior CABG [adjusted odds ratio (aOR) 0.85, 95% confidence interval (CI) 0.85-1.32, p = 0.47]. However, patients with prior CABG had lower odds of periprocedural cardiac complications [aOR 0.72, 95% CI 0.59-0.87, p = 0.001].
CONCLUSIONS: M-TEER appears safe for patients with prior CABG, showing no adverse peri-procedural outcomes compared to those without CABG. Despite more comorbidities, M-TEER remains a safe option for these patients.
METHODOLOGY: We analyzed data from the Nationwide Inpatient Sample, using ICD-10-CM codes for M-TEER and CABG. Primary outcomes included in-hospital all-cause mortality and periprocedural cardiac complications. Inverse probability of treatment weighting was employed to compare M-TEER patients with or without prior CABG.
RESULTS: From January 2016 to December 2020, we identified 48,835 M-TEER cases in the U.S. with 9,655 patients (19.78%) having a prior CABG. These patients were older and had more comorbidities. M-TEER procedures increased over the study period, including those with prior CABG (2,145 in 2016 vs. 2,682 in 2020). Adjusted analysis showed no significant difference in in-hospital mortality between patients with and without prior CABG [adjusted odds ratio (aOR) 0.85, 95% confidence interval (CI) 0.85-1.32, p = 0.47]. However, patients with prior CABG had lower odds of periprocedural cardiac complications [aOR 0.72, 95% CI 0.59-0.87, p = 0.001].
CONCLUSIONS: M-TEER appears safe for patients with prior CABG, showing no adverse peri-procedural outcomes compared to those without CABG. Despite more comorbidities, M-TEER remains a safe option for these patients.