TAVR Outcomes in Severe AS, Aortic Insufficiency

Informing Cardiovascular Clinical Practice With NCDR Data

In addition to helping hospitals, practices and clinicians advance the quality of cardiovascular care and improve patient outcomes, ACC's NCDR suite of registries are an important and robust source of data for practice-changing resource.

This month, Cardiology brings you a roundup of some of the most recent studies using NCDR data to shed light on topics ranging from improving patient outcomes following PCI to understanding of outcomes after TAVR in patients with aortic insufficiency.

In addition, two separate studies focus on geographic availability of TAVR and ways international benchmarking can inform global quality improvement efforts, respectively. Dive in and share your thoughts about the findings on Twitter using #NCDR and #CardiologyMag or join in discussions taking place on the ACC's LinkedIn page.

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Severe aortic stenosis (AS) with concomitant aortic insufficiency (AI) among patients undergoing TAVR may associated with lower mortality and heart failure (HF) hospitalization after one year, according to findings from a study published in the American Heart Journal.

Bhaskar Bhardwaj, MD, et al., used data from the STS/ACC TVT Registry to analyze prevalence of severe AS with concomitant AI among patients undergoing TAVR and look at TAVR outcomes in this population.

The researchers identified 54,535 patients with severe AS with or without concomitant AI who underwent TAVR at 442 sites between 2011 and 2016. Patients were categorized into four groups based on the severity of AI at baseline: isolated severe AS, severe AS with trace or mild AI, severe AS with moderate AI, and severe AS with severe AI.

The study's primary endpoints were one-year rates of all-cause mortality and HF hospitalization. The researchers linked registry data with CMS claims data from to assess one-year outcomes.

Linked CMS data were available for 63.6% of patients (34,678). The risk of mortality and HF hospitalization decreased with increasing severity of pre-TAVR AI. Mortality decreased by 6% for every one grade increase in preprocedure AI (hazard ratio [HR], 0.94 per one grade increase in AI severity; 95% CI, 0.91-0.98; p<0.001).

For HF hospitalization, each one grade increase in preprocedure AI was associated with a 13% decrease in HF hospitalization (HR, 0.87 per one grade increase in AI severity; 95% CI, 0.84-0.91, p<0.001).

According to the researchers, baseline AI was associated with lower procedural success but lower rates of mortality and HF hospitalization after one year. Additional research with baseline and follow-up echocardiographic data is needed to better understand why patients with baseline AI in patients have lower mortality and HF hospitalization, they conclude.

Don't Miss Out! ACC Quality Summit Virtual

Register now for ACC Quality Summit Virtual, scheduled for Oct. 8 – 9, to experience phenomenal speakers, including Quinn Capers, IV, MD, FACC, who will deliver the Ralph G. Brindis Keynote Lecture.

Capers, an interventional cardiologist and professor of internal medicine and vice dean for faculty affairs at the Ohio State University College of Medicine, will discuss ACC's commitment to improving diversity and inclusion in the cardiovascular workforce and in ACC's leadership and membership.

Learn how a diversity of backgrounds, experiences, ideas and perspectives can lead to improved health care outcomes.

In addition, ACC Quality Summit Virtual will provide attendees with NCDR registry-specific and hospital industry knowledge, plus a deeper understanding of the value of accreditation and how patient data can drive process improvement initiatives.

This year's ACC Quality Summit Virtual will focus on diversity, equity and inclusion; providing leadership tactics to improve outcomes; achieving advanced quality efforts; and evaluating quality care in the COVID-19 era.

Registration is free and open to all.

Participants will be able to gain immediate access to on-demand sessions, submit questions to expert faculty and connect with exhibitors.

Register now.

Keywords: ACC Publications, Cardiology Magazine, COVID-19, Prevalence, Pandemics, severe acute respiratory syndrome coronavirus 2, Social Change, Developing Countries, Cardiovascular Diseases, American Heart Association, World Health Organization, Politics, Registries, Myocardial Infarction, Morbidity, Global Health


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