Short-Term Outcomes of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Kidney Transplant Recipients (from the US Nationwide Representative Study)
Section snippets
Methods
We performed a retrospective cohort study following the STROBE checklist and using the NRD database released by the Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ).3 The NRD is a nationally representative database of hospital admissions in United States (US) non-federal hospitals. It includes up to 17 million discharges each year in up to 27 states, accounting for about 57% of all hospitalizations in the US and providing discharge weights
Results
Our study included 2,040 KTR patients who underwent an AVR procedure, of which 762 underwent TAVI, and 1,278 underwent SAVR. KTRs represented 0.4% and 0.3% of all TAVI and SAVR patients in the NRD, respectively. TAVI patients were more likely to have CHF, hypertension, liver disease, DM, dyslipidemia, obesity, a history of myocardial infarction, and a history of a stroke and/or TIA, but less likely to have atrial fibrillation and atrial flutter (Table 1). Although the number of SAVR procedures
Discussion
Using contemporary nationwide data, our main findings suggest that TAVI in KTRs is a safe alternative to SAVR with favorable short-term outcomes. To our knowledge, there have been few published reports focusing on outcomes of aortic valve replacement (AVR) in KTRs.6, 7, 8, 9 In respect of both SAVR and TAVI, very limited studies addressed outcomes of SAVR and TAVI in the unique KTRs population.6,8,10,11
In the present study, KTRs who underwent TAVI were older and had higher frequencies of
Disclosure
The authors declare no conflict of interest.
Ethical Approval
This study was exempted from the institutional review board's approval because it used anonymized and de-identified data in a publicly available database.
Credit Author Statement
Omar M. Abdelfattah and Anas M. Saad: Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Writing – original draft; Abdelrahman Aboshouk, Mohamed Hassanein, and Toshiaki Isogai: Conceptualization, Methodology, Writing - original draft; Mohamed M. Gad and Keerat Rai Ahuja: Visualization, Software, Writing – review & editing; James Yun and Amar Krishnaswamy: Conceptualization, Supervision, Validation, Writing – review & editing; Samir Kapadia:
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this study.
Acknowledgments
This work was made possible by a generous gift from Jennifer and Robert McNeil. The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, and the preparation, review, or approval of the manuscript.
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These authors contributed equally to this work and are considered joint first authors