Abstract 15350: In-Hospital Outcomes of Transcatheter Aortic Valve Implantation in Patients With Peripheral Arterial Disease: Insights From the Nationwide Readmissions Database

Abstract

Introduction: Peripheral arterial disease (PAD) is associated with higher inpatient mortality among patients undergoing endovascular procedures. There is a paucity of data on the impact of PAD on clinical outcomes among patients undergoing transcatheter aortic valve implantation (TAVI). HypothesisPAD does not alter the clinical outcomes among patients undergoing TAVI. Methods: The National Readmission Database (NRD) from 2015-2019 was utilized to select patients with PAD undergoing TAVI. The adjusted odds ratio (OR) of net adverse cardiovascular events (NACE), its components (mortality, stroke), and major post-procedure complications were compared using a propensity-score-matched (PSM) analysis. Results: Using PSM, a total of 14,925 TAVI patients, 7,386 with PAD and 7,539 with no PAD were selected. At index admission, patients with PAD had significantly higher odds of NACE (5.10% vs 3.30% OR 1.60, 95% CI 1.36 to 1.88), and in-hospital mortality (2.10% vs. 0.50% OR 4.10, 95% CI 2.88-5.83) compared with patients without PAD. However, the odds of stroke (OR 1.00, 95% CI 0.74 to 1.35), major bleeding (OR 1.15, 95% CI 0.91-1.45), acute kidney injury (OR 0.98, 95% CI 0.90-1.08), cardiac tamponade (OR 0.88, 95% CI 0.59-1.32), valvular complications (OR 1.15, 95% CI 0.78-1.69), and cardiogenic shock (OR 1.62, 95% CI 0.97-2.70) were not significantly different between the two groups. Contrary to the index admission, there was no significant difference in the 30-day outcomes of patients with PAD and without PAD undergoing TAVI. Conclusion: TAVI in patients with PAD might be associated with a higher risk of NACE, and in-hospital mortality during the hospitalization of the index procedure. However, these complications attenuated at a follow-up of 30-days. The risk of other post-procedure complications remained similar between the two groups.