TAVR Outcomes in the United States From 2011–2014 Compared in Patients With and Without Advanced Renal Dysfunction

October 17, 2017—In Circulation: Cardiovascular Interventions, Divyanshu Mohananey, MD, et al published findings from a study that aimed to compare in-hospital outcomes of transcatheter aortic valve replacement (TAVR) for patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) to those patients with no CKD/ESRD.

The background of the investigation is that renal dysfunction is intricately linked to aortic stenosis with > 25% patients presenting for TAVR having CKD and that the prevalence and outcomes of patients with CKD, especially those with ESRD, are controversial.

As summarized in Circulation: Cardiovascular Interventions, the investigators obtained data using the National Inpatient Sample between the years 2011 and 2014. They used the International Classification of Diseases, Ninth Edition, Clinical Modification procedure codes 350.5 and 350.6 to identify patients undergoing TAVR. The primary outcome of interest was in-hospital mortality. A two-tailed P value < .01 was considered to denote statistical significance for all analyses.

The investigators identified 42,189 patients who underwent TAVR between 2011 and 2014, of whom 62.1% (n = 26,229) had no CKD/ESRD, 33.7% (n = 14,252) had CKD, and 4% (n = 1,708) had ESRD. Patients with CKD or ESRD had greater in-hospital mortality, hospital length of stay, hemorrhage requiring transfusion, and permanent pacemaker implantation (P < .001).

Patients with CKD and ESRD have increased in-hospital mortality and periprocedural adverse events with longer hospital length of stay when compared to those without CKD, concluded the investigators in Circulation: Cardiovascular Interventions.