Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer

Watanabe, Yusuke; Kozuma, Ken; Hioki, Hirofumi; Kawashima, Hideyuki; Nara, Yugo; Kataoka, Akihisa; Shirai, Shinichi; Tada, Norio; Araki, Motoharu; Takagi, Kensuke; Yamanaka, Futoshi; Yamamoto, Masanori; Hayashida, Kentaro

doi:10.1016/j.amjcard.2016.05.052

Cited by 86 publications

(89 citation statements)

References 14 publications

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“…However, the trend toward a higher cardiovascular mortality disappeared after 1 year; supporting the first explanation and suggesting that this finding is by chance. Our results are in contrast to the study by Watanabe et al reporting unaffected 1‐year mortality in Japanese cancer patients compared to controls. Variances in tumor type distribution and racial disparities might have contributed to this difference.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, little is known about patients undergoing TAVR that are either currently suffering from an active cancer disease (ACD) or that previously had a tumor disease (HCD). One study including 47 cancer patients undergoing TAVR found similar acute outcomes and midterm survival rates compared to non‐cancer patients in Japan . But data are still limited and, therefore, we aimed to determine the prevalence, clinical characteristics, perioperative outcomes, and 1‐year mortality of patients with severe aortic stenosis and ACD undergoing TAVR in a real‐world cohort of patients treated in a single center.…”

Section: Introductionmentioning

confidence: 99%

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Impact of active cancer disease on the outcome of patients undergoing transcatheter aortic valve replacement

Mangner

Woitek

Haußig

et al. 2017

J Interven Cardiology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of active cancer disease on the outcome of patients undergoing transcatheter aortic valve replacement

Mangner

Woitek

Haußig

et al. 2017

J Interven Cardiology

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“…The OCEAN-TAVI is an ongoing multicenter registry in 14 relatively high-volume centers in Japan. [12][13][14] Initially, we excluded 262 patients with missing data, 36 patients with a nonelective situation before TAVR, and 59 patients who could not undergo the study examination because of severe clinical symptoms, such as dyspnea or heart failure. Thus, the final sample included the remaining 1256 patients (Figure 1).…”

Section: Study Populationmentioning

confidence: 99%

“…[12][13][14] The Edwards SAPIEN-XT (Edwards; Edwards Lifesciences, Irvine, CA) balloon-expandable prosthesis was first introduced in Japan in October 2013; the Medtronic CoreValve revalving system (Corevalve; Medtronic, Minneapolis, MN) self-expandable prosthesis was used starting in January 2016. The size of the bioprosthesis was determined mainly using multidetector computed tomographic findings or echocardiography, based on the individual center examinations.…”

Section: Tavi Procedures and Data Definitionmentioning

confidence: 99%

Gait Speed Can Predict Advanced Clinical Outcomes in Patients Who Undergo Transcatheter Aortic Valve Replacement

Kano¹,

Yamamoto²,

Shimura³

et al. 2017

Circ: Cardiovascular Interventions

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R ecently, the indication for transcatheter aortic valve replacement (TAVR) has been expanded not only to patients with degenerative aortic stenosis considered inoperable or of high surgical risk but also to those with intermediate surgical risk. [1][2][3] Thus, optimal patient risk stratification should be performed before the TAVR procedure. Frailty, which is not captured in the classical surgical risk model, is considered highly prevalent in elderly vulnerable patients and can be characterized by Background-Gait speed reflects an important factor of frailty and is associated with an increased risk of late mortality in patients with cardiac disease. This study sought to assess the prognostic value of gait speed in elderly patients who underwent transcatheter aortic valve replacement. Methods and Results-We investigated the 5-m or 15-feet gait speed (m/sec) in 1256 patients who underwent transcatheter aortic valve implantation using data from the OCEAN-TAVI Japanese multicenter registry (Optimized Catheter Valvular Intervention-Transcatheter Aortic Valve Implantation). Baseline characteristics, procedural outcomes, and all-cause mortality were compared among groups defined by differential gait speed classification: model 1, normal (>0.83 m/sec; n=563; 44.8%), slow (0.5-0.83 m/sec; n=429; 34.2%), slowest (<0.83 m/sec; n=205; 16.3%), unable to walk (n=48; 3.8%); and model 2, classification and regression tree survival model indicating the threshold of gait speed as 0.385 m/sec (>0.385 m/sec; n=1080 versus ≤0.385 m/sec; n=117). The cumulative 1-year mortality rate showed significant differences in the classical gait speed groups in model 1 (7.6%, 6.6%, 18.2%, and 40.7%, respectively; P<0.001) and survival classification and regression tree group in model 2 (7.7% versus 21.9%; P<0.001). The slowest walkers and those unable to walk demonstrated independent associations with increased midterm mortality after adjustment for several confounding factors (hazard ratio, 1.83, 4.28; 95% confidence interval, 1.03-3.26, 2.22-8.72; P=0.039, <0.001, respectively). Gait speed <0.385 m/sec determined by classification and regression tree also independently associated with worse prognosis (hazard ratio, 2.40; 95% confidence interval, 1.75-5.88; P=0.001). Conclusions-Gait speed using both traditional and specific classification is useful as a potential marker for predicting vulnerable patients associated with adverse clinical outcomes after transcatheter aortic valve replacement. (Circ Cardiovasc Interv. 2017;10:e005088.

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“…Once admitted to the ICCU, physicians are faced with the dilemma of treating these patients with invasive procedures versus conservative therapy, which is often less favorable [13]. A recent study compared the results of TAVI in cancer and noncancer patients, and found no difference between the 2 groups with regard to their outcomes [14]. In accord with our findings, about 10 percent of patients with malignancies underwent TAVI, and none of them died at 30 days of follow-up.…”

Section: Discussionmentioning

confidence: 99%

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

Mazin

Matetzky²,

Shemer³

et al. 2017

Cardiology

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Objectives: During the past decade, the most common causes of mortality and morbidity were cardiovascular diseases and malignancies. The aim of the current study was to describe the incidence, course of admission, and short-term (30-day) prognosis of patients with and without malignancy, admitted to a tertiary center intensive cardiovascular care unit (ICCU). Methods: A prospective observational study of 2,259 patients admitted to the ICCU was conducted between January 2014 and December 2015. Patients with malignancies (n = 256) were divided into 2 groups: those with solid and those with homogenous tumors. Results: The time of diagnosis was categorized into 3 patient groups: recent (<6 months), 59 patients (23%); late (6-24 months), 49 patients (19%), and very late (>24 months), 148 patients (58%). Those with a history of malignancy were older (73 ± 12 vs. 64 ± 15, p < 0.001) and were more likely to be female (p = 0.002). After using a multivariate logistic regression model analysis, no differences were found in therapeutic interventions and clinical outcomes, including major bleeding and acute renal failure, between patients with and without malignancies. Conclusions: Patients with a malignancy comprised about 10% of the entire ICCU population. While mortality was independently associated with advanced age, renal failure, and a diagnosis of ST-elevation myocardial infarction, malignancy alone was not found to be independently associated with a higher mortality rate at 30 days of follow-up.

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Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer

Cited by 86 publications

References 14 publications

Impact of active cancer disease on the outcome of patients undergoing transcatheter aortic valve replacement

Impact of active cancer disease on the outcome of patients undergoing transcatheter aortic valve replacement

Gait Speed Can Predict Advanced Clinical Outcomes in Patients Who Undergo Transcatheter Aortic Valve Replacement

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

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