Ankle–brachial pressure index as a predictor of the 2-year outcome after transcatheter aortic valve replacement: data from the Japanese OCEAN-TAVI ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-12-11

AUTHORS

Masahiro Yamawaki, Motoharu Araki, Tsutomu Ito, Yosuke Honda, Takahiro Tokuda, Yoshiaki Ito, Hiroshi Ueno, Kazuki Mizutani, Minoru Tabata, Akihiro Higashimori, Norio Tada, Kensuke Takagi, Futoshi Yamanaka, Toru Naganuma, Yusuke Watanabe, Masanori Yamamoto, Shinichi Shirai, Kentaro Hayashida, On behalf of OCEAN-TAVI Registry

ABSTRACT

Peripheral artery disease plays a pivotal role for access site selection in transcatheter aortic valve replacement (TAVR). Abnormal ankle–brachial index (ABI) is a generalized mortality marker in many cardiovascular scenarios. However, the long-term outcomes in high-risk TAVR populations remain unclear. We investigated the association between low ABI and 2-year outcome after TAVR. Of 1613 patients enrolled in the OCEAN-TAVI registry, 1458 (90.4%) who underwent ABI before TAVR were divided into groups: patients with (1) ABI ≥ 0.9 in both legs and (2) ABI < 0.9 in either leg. Primary endpoint was all-cause death within 2 years. ABI < 0.9 was noted in 304 patients (20.8%). ABI < 0.9-group had more frequent and severe comorbidities. Primary endpoint in ABI < 0.9-group was significantly higher than that in ABI ≥ 0.9-group (15.8 vs. 8.7%, p < 0.001). This trend continued in the transfemoral (TF)-approach (14.9 vs. 7.5%, p < 0.001), but not in the alternative approach (17.2 vs. 15.8%, p = 0.815). Within 30 days, ABI < 0.9-group had a higher cardiac death rate (3.1 vs. 1.0%, p = 0.033), whereas between 31 days and 2 years, non-cardiovascular death was more frequently observed (9.2 vs. 5.1%, p = 0.003). In ABI < 0.9-group, in-hospital vascular complications (11.9 vs. 4.9%, p < 0.001) and acute kidney injury (10.8 vs, 5.7%, p = 0.009) were more frequently found when using the transfemoral-approach. In multivariate analysis, ABI < 0.9 was an independent predictor of 2-year mortality (adjusted hazard ratio 1.495, 95% CI 1.007–2.220, p = 0.046). Pre-procedure ABI < 0.9 is a useful prognostic marker for all-cause mortality, even in high-risk TAVR populations. More... »

PAGES

640-650

Journal

TITLE

Heart and Vessels

ISSUE

6

VOLUME

33

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-017-1096-y

DOI

http://dx.doi.org/10.1007/s00380-017-1096-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1099698185

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29230568


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