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WASHINGTON (Oct 01, 2019) -
Data from the American College of Cardiology's NCDR was the source of several studies published and presented in recent months, including studies examining different approaches and outcomes to transcatheter aortic valve replacement (TAVR)—including the relationship between procedure volume and mortality at hospitals performing the procedure—and readmission rates for heart failure and heart attack patients.
Are There Better Outcomes in Transaxillary TAVR vs. Other Approaches?
Patients undergoing balloon-expandable TAVR via transaxillary access may have better 30-day outcomes compared with patients undergoing the procedure via other nontransfemoral approaches, according to a study published April 1 in JACC: Cardiovascular Interventions. Thom G. Dahle, MD, FACC, et al., used the STS/ACC TVT Registry to evaluate frequency and 30-day outcomes of patients undergoing balloon-expandable TAVR via transfemoral access vs. transaxillary or transapical or transaortic access. In addition, propensity matching was used to compare outcomes in nontransfemoral patients between those receiving transaxillary access vs. those receiving transapical or transaortic access. Read more.
New Study Shows Relationship Between Volume-Mortality For TAVR Hospitals, Operators
Hospitals and operators performing a higher volume of TAVR procedures may have lower 30-day mortality rates that persist one year into a hospital's experience with TAVR, according to a study published April 3 in the New England Journal of Medicine. Sreekanth Vemulapalli, MD, et al., used data from the STS/ACC TVT Registry to look at 99,256 patients undergoing transfemoral TAVR at 554 sites by 2,935 operators. The authors examined the association between hospital and operator procedural volume and 30-day mortality rates for TAVR procedures to assess whether a volume-outcomes association persists six months and one year after a hospital begins performing TAVR. Read more.
Communication, Patient Navigator Resources May Lead to Lower Acute Myocardial Infarction, Heart Failure Readmissions; Process Improvements
Hospitals participating in ACC's Patient Navigator Program: Focus MI that implement team communication methods and use Patient Navigator resources may be more likely to improve care processes and have lower readmission rates for patients with acute myocardial infarction (AMI) and heart failure (HF), according to two abstracts presented April 6 at the 2019 Quality of Care and Outcomes Research Scientific Sessions in Arlington, VA. Read more.
RAS Inhibitors Associated with Lower One-Year Mortality, Heart Failure Readmission in TAVR Patients
TAVR patients who receive a prescription for a renin-angiotensin system (RAS) inhibitor at discharge may have lower rates of mortality and heart failure readmission after one year, according to a study recently published in the Journal of the American Medical Association. Taku Inohara, MD, PhD, et al., used the STS/ACC TVT Registry to assess the association of prescription RAS inhibitors and TAVR outcome in 21,312 patients who underwent TAVR at 417 U.S. hospitals between July 2014 and January 2016. Primary outcomes were all-cause mortality and heart failure readmission at one year. Read more.
BVS Uptake Decreased Following Release of Adverse Events Data
There was a "modest" uptake of bioresorbable vascular scaffolds (BVS) in PCI procedures in the 90 days after the U.S. Food and Drug Administration (FDA) approved the device, followed by a decline when new data reported negative outcomes, according to a study published May 8 in JAMA Cardiology. Katherine Hsin-Yu Chau, MD, et al., used data from ACC's CathPCI Registry to examine patterns in BVS uptake after FDA approval and changes in uptake following the release of new adverse event data and FDA warnings. The primary outcome was monthly use of BVS among all PCI procedures. Researchers also looked at characteristics of patients who received a BVS and of hospitals that used the device. Read more.
Racial Minorities Less Likely to Undergo TAVR, NCDR Study Shows
Racial minorities may be less likely than white patients to undergo TAVR in the U.S., but their in-hospital and one-year outcomes following TAVR are similar to those of white patients, according to a study published May 20 in JACC: Cardiovascular Interventions. Mohamad Alkhouli, MD, FACC, et al., used the STS/ACC TVT Registry to analyze records of 70,221 patients age 65 and older who underwent TAVR. The researchers linked registry data to claims data from the Centers for Medicare and Medicaid Services to assess one-year outcomes in a subset of 29,351 patients. The study's primary outcome was in-hospital and one-year all-cause mortality. Read more.
Mortality Rate After TAVR Higher in Dialysis-Dependent Patients, NCDR Study Finds
Patients undergoing TAVR who have end-stage renal disease (ESRD) and are dialysis-dependent may have a higher risk of mortality than patients who are not dependent on dialysis, according to a study published June 3 in the Journal of the American College of Cardiology. Using data from the STS/ACC TVT Registry, Molly Szerlip, MD, FACC, et al., looked at 72,631 patients with severe aortic stenosis treated with TAVR, and compared in-hospital and one-year outcomes in ESRD vs. nondialysis patients. Read more.
Mortality Following TMVR Higher in Patients with Renal Disease, NCDR Study Shows
Patients undergoing transcatheter mitral valve repair (TMVR) with MitraClip who have renal disease may have a significantly higher mortality risk than those without renal disease, according to a study published Feb. 1 in Circulation: Cardiovascular Interventions. Using data from the STS/ACC TVT Registry, Binita Shah, MD, MS, FACC, et al., evaluated the rates of adverse outcomes in 5,213 patients with renal disease undergoing TMVr at 204 hospitals. The study's primary outcome was the composite of in-hospital all-cause mortality, stroke or new requirement for dialysis based on creatine clearance. The researchers linked patient records to claims data from the Centers for Medicare and Medicaid Services for 3,300 patients to look at 30-day and one-year rates of all-cause mortality, mitral valve reintervention, and readmission related to heart failure or bleeding. Read more.
Guideline-Concordant CRT-D Implants Have Increased, NCDR Study Finds
The rate of cardiac resynchronization therapy defibrillator (CRT-D) implantations that were guideline-concordant increased following an October 2012 update regarding patient selection in the device-based therapy guideline, according to a study published June 19 in JAMA Cardiology. Amneet Sandhu, MD, MSc, used data from ACC'sICD Registry to evaluate the changing state of CRT-D use in the U.S. following the release of the 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. The researchers looked at CRT-D trends, factors associated with guideline-concordant and guideline-discordant implantation, and hospital-based variations in guideline-based CRT-D implantation. Read more.
NCDR data and news was also previously highlighted. Read more:
The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its more than 52,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.