Abstract 11771: Co-Morbid Amyloidosis Leads to Higher In-Hospital Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement: Analysis of National Inpatient Sample

Abstract

Introduction: Amyloidosis is a common comorbidity in elderly patients with aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR). We sought to determine the impact of amyloidosis on the clinical outcomes of TAVR. Methods: Data were extracted from the National Inpatient Sample (NIS) 2016 - 2018 database. The NIS was searched for adult patients who underwent TAVR during hospitalization with and without amyloidosis as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality. Secondary outcomes are shown in table 1. Periprocedural complications consisted of intra-operative hemorrhage, accidental rupture and laceration of a circulatory system organ, intra-operative cardiac functional disturbances, intra-operative cardiac functional disturbances and perioperative cerebrovascular infarction. Multivariate logistic and linear regression analysis were used accordingly to adjust for confounders. STATA software was used for analysis. Results: Of the148315 patients undergoing TAVR in 2016 - 2018, 150 (0.1%) had secondary diagnosis of amyloidosis. Mean age at the time of TAVR was comparable in both groups (79.4 years, 95% CI 76.5 - 82.3 vs. 79.6 years, 95% CI 79.5 - 79.8; p=0.865). There were 30% females in the amyloidosis group vs. 46% in the other group (p=0.081).The adjusted odds ratio (aOR) for in-hospital mortality for patients undergoing TAVR with comorbid amyloidosis than those without amyloidosis was 4.77 (95% CI 1.06 - 21.49, p=0.042). Patients with amyloidosis had a similar mean difference in length of stay and total hospital charges. Comorbid amyloidosis was not associated with higher odds of peri-procedural cardiovascular complications (aOR: 1.18, 95% CI 0.36 - 3.82, p=0.786). Detailed outcomes are listed in table 1. Conclusions: Comorbid amyloidosis leads to higher inpatient mortality but similar rates of peri-procedural cardiovascular complications in patients undergoing TAVR.