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Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer
Background Patients with cancer and severe aortic stenosis are often ineligible for surgical aortic valve replacement (SAVR). Patients with cancer may likely benefit from emerging transcatheter aortic valve replacement (TAVR), given its minimally invasive nature. Methods and Results The US-based Nat...
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| Published in: | Journal of the American Heart Association 2020-01, Vol.9 (2), p.e014248-e014248 |
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| creator | Guha, Avirup Dey, Amit K Arora, Sameer Cavender, Matthew A Vavalle, John P Sabik, III, Joseph F Jimenez, Ernesto Jneid, Hani Addison, Daniel |
| description | Background Patients with cancer and severe aortic stenosis are often ineligible for surgical aortic valve replacement (SAVR). Patients with cancer may likely benefit from emerging transcatheter aortic valve replacement (TAVR), given its minimally invasive nature. Methods and Results The US-based National Inpatient Sample was queried between 2012 and 2015 using
(
), codes to identify all hospitalized adults (aged ≥50 years), who had a primary diagnosis of aortic stenosis. We examined the effect modification of cancer on the relative use rate, outcomes, and dispositions associated with propensity-matched cohort TAVR versus SAVR. Overall, 47 295 TAVRs (22.6% comorbid cancer) and 113 405 SAVRs (15.2% comorbid cancer) were performed among admissions with aortic stenosis between 2012 and 2015. In the year 2015, patients with cancer saw relatively higher rates of TAVR use compared with SAVR (relative use rate
versus relative use rate
, 67.8% versus 57.2%; |
| doi_str_mv | 10.1161/JAHA.119.014248 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_a3a7fdc971db418bae024ebe86d5588b</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_a3a7fdc971db418bae024ebe86d5588b</doaj_id><sourcerecordid>2343038653</sourcerecordid><originalsourceid>FETCH-LOGICAL-c459t-15cc9f11f8ed6bd31d408a965cbd3ac70b01c8f82aa0da3cc51c8ba9f1f3f72f3</originalsourceid><addsrcrecordid>eNpVkcFPHSEQxjdNm2rUc28Nx16ewrLswqXJy0utNiaa1rZHMgvDc80uvAJr0v--vK4a5cI3MPNjhq-qPjB6yljLzr6tL9ZFqVPKmrqRb6rDmjbdSilJ377QB9VJSve0rLbuuFDvqwPOVEs7wQ4rvwk-47QLEeJfchvR20TAW3I9ZxMmTCQ4coPRzBk8hnm5_DHH7WBgJOsQ82DILxgfkHzH3QgGJ_SZDJ7cQB6KTOT3kO_IBrzBeFy9czAmPHncj6qf519uNxerq-uvl5v11co0QuUVE8Yox5iTaNvecmYbKkG1wpQATEd7yox0sgagFrgxooQ9lBLHXVc7flRdLlwb4F7v4jCV8XSAQf8_CHGrYd_5iBo4dM4a1THbN6xQkNYN9ihbK4SUfWF9Xli7uZ_QmjJThPEV9PWNH-70NjzojnIumSyAT4-AGP7MmLKehmRwHJcf1TVvOOWyFbykni2pJoaUIrrnZxjVe9P13vSilF5MLxUfX3b3nP9kMf8Hy-eqxA</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2343038653</pqid></control><display><type>article</type><title>Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer</title><source>Wiley Online Library Open Access</source><source>PubMed Central</source><creator>Guha, Avirup ; Dey, Amit K ; Arora, Sameer ; Cavender, Matthew A ; Vavalle, John P ; Sabik, III, Joseph F ; Jimenez, Ernesto ; Jneid, Hani ; Addison, Daniel</creator><creatorcontrib>Guha, Avirup ; Dey, Amit K ; Arora, Sameer ; Cavender, Matthew A ; Vavalle, John P ; Sabik, III, Joseph F ; Jimenez, Ernesto ; Jneid, Hani ; Addison, Daniel</creatorcontrib><description>Background Patients with cancer and severe aortic stenosis are often ineligible for surgical aortic valve replacement (SAVR). Patients with cancer may likely benefit from emerging transcatheter aortic valve replacement (TAVR), given its minimally invasive nature. Methods and Results The US-based National Inpatient Sample was queried between 2012 and 2015 using
(
), codes to identify all hospitalized adults (aged ≥50 years), who had a primary diagnosis of aortic stenosis. We examined the effect modification of cancer on the relative use rate, outcomes, and dispositions associated with propensity-matched cohort TAVR versus SAVR. Overall, 47 295 TAVRs (22.6% comorbid cancer) and 113 405 SAVRs (15.2% comorbid cancer) were performed among admissions with aortic stenosis between 2012 and 2015. In the year 2015, patients with cancer saw relatively higher rates of TAVR use compared with SAVR (relative use rate
versus relative use rate
, 67.8% versus 57.2%;
<0.0001). Among patients with cancer, TAVR was associated with lower odds of acute kidney injury (odds ratio, 0.64; 95% CI, 0.54-0.75) and major bleeding (odds ratio, 0.44; 95% CI, 0.38-0.51]), with no differences in in-hospital mortality and stroke compared with SAVR. In addition, TAVR was associated with higher odds of home discharge (odds ratio, 1.92; 95% CI, 1.68-2.19) compared with SAVR among patients with cancer. Lower risk of acute kidney injury was noted in cancer versus noncancer (
<0.001) undergoing TAVR versus SAVR in effect modification analysis. Conclusions TAVR use has increased irrespective of cancer status, with a greater increase in cancer versus noncancer. In patients with cancer, there was an association of TAVR with lower periprocedural complications and better disposition when compared with patients undergoing SAVR.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.119.014248</identifier><identifier>PMID: 31960751</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve - diagnostic imaging ; Aortic Valve - surgery ; aortic valve replacement ; Aortic Valve Stenosis - diagnostic imaging ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - surgery ; Cardio‐Oncology Spotlight ; Databases, Factual ; epidemiology ; Female ; Heart Valve Prosthesis Implantation - adverse effects ; Heart Valve Prosthesis Implantation - mortality ; Heart Valve Prosthesis Implantation - trends ; Hospital Mortality ; Humans ; Inpatients ; Male ; Middle Aged ; Neoplasms - diagnosis ; Neoplasms - epidemiology ; Neoplasms - mortality ; oncology ; Original Research ; Outcome and Process Assessment, Health Care - trends ; Postoperative Complications - mortality ; Risk Assessment ; Risk Factors ; Time Factors ; transcatheter aortic valve ; Transcatheter Aortic Valve Replacement - adverse effects ; Transcatheter Aortic Valve Replacement - mortality ; Transcatheter Aortic Valve Replacement - trends ; Treatment Outcome ; United States - epidemiology</subject><ispartof>Journal of the American Heart Association, 2020-01, Vol.9 (2), p.e014248-e014248</ispartof><rights>2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-15cc9f11f8ed6bd31d408a965cbd3ac70b01c8f82aa0da3cc51c8ba9f1f3f72f3</citedby><cites>FETCH-LOGICAL-c459t-15cc9f11f8ed6bd31d408a965cbd3ac70b01c8f82aa0da3cc51c8ba9f1f3f72f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033818/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033818/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31960751$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guha, Avirup</creatorcontrib><creatorcontrib>Dey, Amit K</creatorcontrib><creatorcontrib>Arora, Sameer</creatorcontrib><creatorcontrib>Cavender, Matthew A</creatorcontrib><creatorcontrib>Vavalle, John P</creatorcontrib><creatorcontrib>Sabik, III, Joseph F</creatorcontrib><creatorcontrib>Jimenez, Ernesto</creatorcontrib><creatorcontrib>Jneid, Hani</creatorcontrib><creatorcontrib>Addison, Daniel</creatorcontrib><title>Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description>Background Patients with cancer and severe aortic stenosis are often ineligible for surgical aortic valve replacement (SAVR). Patients with cancer may likely benefit from emerging transcatheter aortic valve replacement (TAVR), given its minimally invasive nature. Methods and Results The US-based National Inpatient Sample was queried between 2012 and 2015 using
(
), codes to identify all hospitalized adults (aged ≥50 years), who had a primary diagnosis of aortic stenosis. We examined the effect modification of cancer on the relative use rate, outcomes, and dispositions associated with propensity-matched cohort TAVR versus SAVR. Overall, 47 295 TAVRs (22.6% comorbid cancer) and 113 405 SAVRs (15.2% comorbid cancer) were performed among admissions with aortic stenosis between 2012 and 2015. In the year 2015, patients with cancer saw relatively higher rates of TAVR use compared with SAVR (relative use rate
versus relative use rate
, 67.8% versus 57.2%;
<0.0001). Among patients with cancer, TAVR was associated with lower odds of acute kidney injury (odds ratio, 0.64; 95% CI, 0.54-0.75) and major bleeding (odds ratio, 0.44; 95% CI, 0.38-0.51]), with no differences in in-hospital mortality and stroke compared with SAVR. In addition, TAVR was associated with higher odds of home discharge (odds ratio, 1.92; 95% CI, 1.68-2.19) compared with SAVR among patients with cancer. Lower risk of acute kidney injury was noted in cancer versus noncancer (
<0.001) undergoing TAVR versus SAVR in effect modification analysis. Conclusions TAVR use has increased irrespective of cancer status, with a greater increase in cancer versus noncancer. In patients with cancer, there was an association of TAVR with lower periprocedural complications and better disposition when compared with patients undergoing SAVR.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve - diagnostic imaging</subject><subject>Aortic Valve - surgery</subject><subject>aortic valve replacement</subject><subject>Aortic Valve Stenosis - diagnostic imaging</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Cardio‐Oncology Spotlight</subject><subject>Databases, Factual</subject><subject>epidemiology</subject><subject>Female</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Heart Valve Prosthesis Implantation - mortality</subject><subject>Heart Valve Prosthesis Implantation - trends</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms - diagnosis</subject><subject>Neoplasms - epidemiology</subject><subject>Neoplasms - mortality</subject><subject>oncology</subject><subject>Original Research</subject><subject>Outcome and Process Assessment, Health Care - trends</subject><subject>Postoperative Complications - mortality</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>transcatheter aortic valve</subject><subject>Transcatheter Aortic Valve Replacement - adverse effects</subject><subject>Transcatheter Aortic Valve Replacement - mortality</subject><subject>Transcatheter Aortic Valve Replacement - trends</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVkcFPHSEQxjdNm2rUc28Nx16ewrLswqXJy0utNiaa1rZHMgvDc80uvAJr0v--vK4a5cI3MPNjhq-qPjB6yljLzr6tL9ZFqVPKmrqRb6rDmjbdSilJ377QB9VJSve0rLbuuFDvqwPOVEs7wQ4rvwk-47QLEeJfchvR20TAW3I9ZxMmTCQ4coPRzBk8hnm5_DHH7WBgJOsQ82DILxgfkHzH3QgGJ_SZDJ7cQB6KTOT3kO_IBrzBeFy9czAmPHncj6qf519uNxerq-uvl5v11co0QuUVE8Yox5iTaNvecmYbKkG1wpQATEd7yox0sgagFrgxooQ9lBLHXVc7flRdLlwb4F7v4jCV8XSAQf8_CHGrYd_5iBo4dM4a1THbN6xQkNYN9ihbK4SUfWF9Xli7uZ_QmjJThPEV9PWNH-70NjzojnIumSyAT4-AGP7MmLKehmRwHJcf1TVvOOWyFbykni2pJoaUIrrnZxjVe9P13vSilF5MLxUfX3b3nP9kMf8Hy-eqxA</recordid><startdate>20200121</startdate><enddate>20200121</enddate><creator>Guha, Avirup</creator><creator>Dey, Amit K</creator><creator>Arora, Sameer</creator><creator>Cavender, Matthew A</creator><creator>Vavalle, John P</creator><creator>Sabik, III, Joseph F</creator><creator>Jimenez, Ernesto</creator><creator>Jneid, Hani</creator><creator>Addison, Daniel</creator><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20200121</creationdate><title>Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer</title><author>Guha, Avirup ; Dey, Amit K ; Arora, Sameer ; Cavender, Matthew A ; Vavalle, John P ; Sabik, III, Joseph F ; Jimenez, Ernesto ; Jneid, Hani ; Addison, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-15cc9f11f8ed6bd31d408a965cbd3ac70b01c8f82aa0da3cc51c8ba9f1f3f72f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve - diagnostic imaging</topic><topic>Aortic Valve - surgery</topic><topic>aortic valve replacement</topic><topic>Aortic Valve Stenosis - diagnostic imaging</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Cardio‐Oncology Spotlight</topic><topic>Databases, Factual</topic><topic>epidemiology</topic><topic>Female</topic><topic>Heart Valve Prosthesis Implantation - adverse effects</topic><topic>Heart Valve Prosthesis Implantation - mortality</topic><topic>Heart Valve Prosthesis Implantation - trends</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms - diagnosis</topic><topic>Neoplasms - epidemiology</topic><topic>Neoplasms - mortality</topic><topic>oncology</topic><topic>Original Research</topic><topic>Outcome and Process Assessment, Health Care - trends</topic><topic>Postoperative Complications - mortality</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>transcatheter aortic valve</topic><topic>Transcatheter Aortic Valve Replacement - adverse effects</topic><topic>Transcatheter Aortic Valve Replacement - mortality</topic><topic>Transcatheter Aortic Valve Replacement - trends</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guha, Avirup</creatorcontrib><creatorcontrib>Dey, Amit K</creatorcontrib><creatorcontrib>Arora, Sameer</creatorcontrib><creatorcontrib>Cavender, Matthew A</creatorcontrib><creatorcontrib>Vavalle, John P</creatorcontrib><creatorcontrib>Sabik, III, Joseph F</creatorcontrib><creatorcontrib>Jimenez, Ernesto</creatorcontrib><creatorcontrib>Jneid, Hani</creatorcontrib><creatorcontrib>Addison, Daniel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guha, Avirup</au><au>Dey, Amit K</au><au>Arora, Sameer</au><au>Cavender, Matthew A</au><au>Vavalle, John P</au><au>Sabik, III, Joseph F</au><au>Jimenez, Ernesto</au><au>Jneid, Hani</au><au>Addison, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2020-01-21</date><risdate>2020</risdate><volume>9</volume><issue>2</issue><spage>e014248</spage><epage>e014248</epage><pages>e014248-e014248</pages><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract>Background Patients with cancer and severe aortic stenosis are often ineligible for surgical aortic valve replacement (SAVR). Patients with cancer may likely benefit from emerging transcatheter aortic valve replacement (TAVR), given its minimally invasive nature. Methods and Results The US-based National Inpatient Sample was queried between 2012 and 2015 using
(
), codes to identify all hospitalized adults (aged ≥50 years), who had a primary diagnosis of aortic stenosis. We examined the effect modification of cancer on the relative use rate, outcomes, and dispositions associated with propensity-matched cohort TAVR versus SAVR. Overall, 47 295 TAVRs (22.6% comorbid cancer) and 113 405 SAVRs (15.2% comorbid cancer) were performed among admissions with aortic stenosis between 2012 and 2015. In the year 2015, patients with cancer saw relatively higher rates of TAVR use compared with SAVR (relative use rate
versus relative use rate
, 67.8% versus 57.2%;
<0.0001). Among patients with cancer, TAVR was associated with lower odds of acute kidney injury (odds ratio, 0.64; 95% CI, 0.54-0.75) and major bleeding (odds ratio, 0.44; 95% CI, 0.38-0.51]), with no differences in in-hospital mortality and stroke compared with SAVR. In addition, TAVR was associated with higher odds of home discharge (odds ratio, 1.92; 95% CI, 1.68-2.19) compared with SAVR among patients with cancer. Lower risk of acute kidney injury was noted in cancer versus noncancer (
<0.001) undergoing TAVR versus SAVR in effect modification analysis. Conclusions TAVR use has increased irrespective of cancer status, with a greater increase in cancer versus noncancer. In patients with cancer, there was an association of TAVR with lower periprocedural complications and better disposition when compared with patients undergoing SAVR.</abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>31960751</pmid><doi>10.1161/JAHA.119.014248</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Aortic Valve - diagnostic imaging Aortic Valve - surgery aortic valve replacement Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - mortality Aortic Valve Stenosis - surgery Cardio‐Oncology Spotlight Databases, Factual epidemiology Female Heart Valve Prosthesis Implantation - adverse effects Heart Valve Prosthesis Implantation - mortality Heart Valve Prosthesis Implantation - trends Hospital Mortality Humans Inpatients Male Middle Aged Neoplasms - diagnosis Neoplasms - epidemiology Neoplasms - mortality oncology Original Research Outcome and Process Assessment, Health Care - trends Postoperative Complications - mortality Risk Assessment Risk Factors Time Factors transcatheter aortic valve Transcatheter Aortic Valve Replacement - adverse effects Transcatheter Aortic Valve Replacement - mortality Transcatheter Aortic Valve Replacement - trends Treatment Outcome United States - epidemiology |
| title | Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer |
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