Prognostic Impact of Underweight (Body Mass Index <20 kg/m 2) in Patients With Severe Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement (from the German Aortic Valve Registry [GARY])
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Prognostic Impact of Underweight (Body Mass Index <20 kg/m 2) in Patients With Severe Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement (from the German Aortic Valve Registry [GARY]). / Voigtländer, Lisa; Twerenbold, Raphael; Schäfer, Ulrich; Conradi, Lenard; Balaban, Ümniye; Bekeredjian, Raffi; Ensminger, Stephan; Walther, Thomas; Beckmann, Andreas; Frerker, Christian; Bauer, Timm; Hamm, Christian; Möllmann, Helge; Bleiziffer, Sabine; GARY Executive Board.
in: AM J CARDIOL, Jahrgang 129, 15.08.2020, S. 79-86.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Prognostic Impact of Underweight (Body Mass Index <20 kg/m 2) in Patients With Severe Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement (from the German Aortic Valve Registry [GARY])
AU - Voigtländer, Lisa
AU - Twerenbold, Raphael
AU - Schäfer, Ulrich
AU - Conradi, Lenard
AU - Balaban, Ümniye
AU - Bekeredjian, Raffi
AU - Ensminger, Stephan
AU - Walther, Thomas
AU - Beckmann, Andreas
AU - Frerker, Christian
AU - Bauer, Timm
AU - Hamm, Christian
AU - Möllmann, Helge
AU - Bleiziffer, Sabine
AU - GARY Executive Board
N1 - Copyright © 2020 Elsevier Inc. All rights reserved.
PY - 2020/8/15
Y1 - 2020/8/15
N2 - According to the Valve Academic Resortium, underweight is one parameter in the definition of frailty, which is associated with increased mortality after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). Aims of our study were (1) to examine the impact of underweight on mortality after TAVI and SAVR and (2) to determine the effect of intervention mode (TAVI vs SAVR) on mortality in underweight patients from the German Aortic Valve Registry. Overall, 35,109 patients treated with TAVI or SAVR were studied. Outcomes of underweight (body mass index [BMI] <20 kg/m2) TAVI and SAVR patients were compared using propensity score weighting. Prevalence of underweight was 5.7% in patients who underwent TAVI and 2.9% in patients who underwent SAVR. Underweight patients had significantly increased mortality rates for both treatment strategies compared with normal weight patients (BMI 20 to 30 kg/m2). Comparing underweight TAVI and SAVR-patients using propensity score weighting, no statistically significant differences regarding mortality rates were observed. Subgroup analysis of severely underweight patients (BMI <18.5 kg/m²) revealed no significant increase of mortality after TAVI compared with underweight patients (BMI <20 kg/m2), whereas severely underweight SAVR patients showed twofold increased mortality rates. In conclusion, underweight in patients who underwent TAVI or SAVR is rare, but it is associated with increased mortality. Especially severely underweight SAVR patients showed excess mortality rates.
AB - According to the Valve Academic Resortium, underweight is one parameter in the definition of frailty, which is associated with increased mortality after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). Aims of our study were (1) to examine the impact of underweight on mortality after TAVI and SAVR and (2) to determine the effect of intervention mode (TAVI vs SAVR) on mortality in underweight patients from the German Aortic Valve Registry. Overall, 35,109 patients treated with TAVI or SAVR were studied. Outcomes of underweight (body mass index [BMI] <20 kg/m2) TAVI and SAVR patients were compared using propensity score weighting. Prevalence of underweight was 5.7% in patients who underwent TAVI and 2.9% in patients who underwent SAVR. Underweight patients had significantly increased mortality rates for both treatment strategies compared with normal weight patients (BMI 20 to 30 kg/m2). Comparing underweight TAVI and SAVR-patients using propensity score weighting, no statistically significant differences regarding mortality rates were observed. Subgroup analysis of severely underweight patients (BMI <18.5 kg/m²) revealed no significant increase of mortality after TAVI compared with underweight patients (BMI <20 kg/m2), whereas severely underweight SAVR patients showed twofold increased mortality rates. In conclusion, underweight in patients who underwent TAVI or SAVR is rare, but it is associated with increased mortality. Especially severely underweight SAVR patients showed excess mortality rates.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve Stenosis/epidemiology
KW - Body Mass Index
KW - Cardiac Output, Low/epidemiology
KW - Coronary Artery Disease/epidemiology
KW - Erythrocyte Transfusion/statistics & numerical data
KW - Female
KW - Germany/epidemiology
KW - Heart Valve Prosthesis Implantation
KW - Humans
KW - Hypertension, Pulmonary/epidemiology
KW - Intensive Care Units
KW - Length of Stay/statistics & numerical data
KW - Male
KW - Middle Aged
KW - Mortality
KW - Postoperative Complications/epidemiology
KW - Prevalence
KW - Prognosis
KW - Pulmonary Disease, Chronic Obstructive/epidemiology
KW - Renal Dialysis/statistics & numerical data
KW - Respiration, Artificial/statistics & numerical data
KW - Severity of Illness Index
KW - Stroke/epidemiology
KW - Stroke Volume
KW - Thinness/epidemiology
KW - Transcatheter Aortic Valve Replacement
U2 - 10.1016/j.amjcard.2020.05.002
DO - 10.1016/j.amjcard.2020.05.002
M3 - SCORING: Journal article
C2 - 32540167
VL - 129
SP - 79
EP - 86
JO - AM J CARDIOL
JF - AM J CARDIOL
SN - 0002-9149
ER -
