Risk Factors For Acute Heart Failure After Tavi
Lukas Stastny, Markus Kofler, Lisa Auinger, Julia Dumfarth, Guy Friedrich, Bernhard Metzler, Michael Grimm, Nikolaos Bonaros.
Medical University of Innsbruck, Innsbruck, Austria.
Background
Acute heart failure is known to be the most frequent cause of hospital readmission after transcatheter aortic valve implantation (TAVI). Furthermore, it is associated with an increased risk of mortality. The aim of the study was to define independent predictors for acute heart failure after TAVI.
Methods
From 2008 to 2017, 298 patients with isolated aortic stenosis undergoing either transfemoral or transapical TAVI were included in this single center study. The primary study endpoint was defined as hospital readmission due to acute heart failure. All analyses were performed as time-to-first event analysis. Stepwise multivariable Cox regression analysis was used to determine independent predictors for acute heart failure.
Results
STS-Score >4.6% (HR 2.481, 95% CI 1.331 - 4.622, p=0,004) and HS-Troponin T >23.3pg/ml (HR 2.892, 95% CI 1.434 - 5.829, p=0,003) were significant prognostic factors after multivariate cox regression. NT-proBNP >2762pg/ml (HR 1.708, 95% CI 0.909 - 3.208, p=0,096) and mean gradient >45mmHg (HR 0.661, 95% CI 0.363 - 1.206, p=0,117) were significant in univariate analysis, but not in multivariate regression analysis.
Conclusion
STS Score and high sensitive Troponin T are independent predictors for acute heart failure after TAVI. N-terminal prohormone of brain natriuretic peptide seems to be less accurate as a risk factor for heart failure after TAVI.
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