Park, Hanbit; Ahn, Jung-Min; Kang, Do-Yoon; Kim, Juyong Brian; Yeung, Alan C; Nishi, Takeshi; Fearon, William F; Cantey, Eric Page; Flaherty, James D; Davidson, Charles J; Malaisrie, S Christopher; Kim, Sehee; Yun, Sung-Cheol; Ko, Euihong; Lee, Seung-Ah; Kim, Dae-Hee; Kim, Ho Jin; Kim, Joon Bum; Choo, Suk Jung; Park, Duk-Woo; Park, Seung-Jung
JACC. Cardiovascular interventions
2021Nov ; 39 ( 18 ) :.
PMID : 34838464
저자 상세정보
Park, Hanbit - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Ahn, Jung-Min - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kang, Do-Yoon - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kim, Juyong Brian - Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA.
Yeung, Alan C - Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA.
Nishi, Takeshi - Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA.
Fearon, William F - Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA.
Cantey, Eric Page - Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Division of Cardiology and Cardiac Surgery, Departments of Medicine and Surgery, Chicago, Illinois, USA.
Flaherty, James D - Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Division of Cardiology and Cardiac Surgery, Departments of Medicine and Surgery, Chicago, Illinois, USA.
Davidson, Charles J - Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Division of Cardiology and Cardiac Surgery, Departments of Medicine and Surgery, Chicago, Illinois, USA.
Malaisrie, S Christopher - Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Division of Cardiology and Cardiac Surgery, Departments of Medicine and Surgery, Chicago, Illinois, USA.
Kim, Sehee - Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Yun, Sung-Cheol - Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Ko, Euihong - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Lee, Seung-Ah - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kim, Dae-Hee - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kim, Ho Jin - Division of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Kim, Joon Bum - Division of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Choo, Suk Jung - Division of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Park, Duk-Woo - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: dwpark@amc.seoul.kr.
Park, Seung-Jung - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: sjpark@amc.seoul.kr.
ABSTRACT
OBJECTIVES: The aim of this study was to compare the incidence and prognostic significance of prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) according to racial groups. BACKGROUND: PPM after TAVR may be of more concern in Asian populations considering their relatively small annular and valve sizes compared with Western populations.
METHODS: TP-TAVR (Transpacific TAVR Registry) was an international multicenter cohort study of patients with severe aortic stenosis who underwent TAVR in the United States and South Korea from January 2015 to November 2019. PPM was defined as moderate (0.65-0.85?cm(2)/m(2)) or severe (<0.65?cm(2)/m(2)) at the indexed effective orifice area. The primary outcome was a composite of death, stroke, or rehospitalization at 1 year.
RESULTS: Among 1,101 eligible patients (533 Asian and 569 non-Asian), the incidence of PPM was significantly lower in the Asian population (33.6%; moderate, 26.5%; severe, 7.1%) than in the non-Asian population (54.5%; moderate, 29.8%; severe, 24.7%). The 1-year rate of the primary outcome was similar between the PPM and non-PPM groups (27.5% vs 28.1%; P?=?0.69); this pattern was consistent between Asian (25.4% vs 25.2%; P?=?0.31) and non-Asian (28.7% vs 32.1%; P?=?0.97) patients. After multivariable adjustment, the risk for the primary outcome did not significantly differ between the PPM and non-PPM groups in the overall population (HR: 0.95; 95% CI: 0.74-1.21), in Asian patients (HR: 1.07; 95%?CI: 0.74-1.55), and in non-Asian patients (HR: 0.86; 95%?CI: 0.63-1.19).
CONCLUSIONS: In this study of patients with severe aortic stenosis who underwent TAVR, the incidence of PPM was significantly lower in Asian patients than in non-Asian patients. The 1-year risk for the primary composite outcome was similar between the PPM and non-PPM groups regardless of racial group. (Transpacific TAVR Registry [TP-TAVR]; NCT03826264). CI - Copyright ??2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
keyword
TAVR; aortic valve stenosis; mortality; outcomes
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