JACC:退伍军人接受TAVR的结局

2019-11-28 xiangting MedSci原创

在VA中心接受TAVR治疗的退伍军人主要是老年男性,合并症严重。30天的临床结局、再入院率及1年死亡率优于VA以外的基准结局数据。

这项研究旨在描述在美国退伍军人事务部(VA)中心接受经导管主动脉瓣置换术TAVR)退伍军人的临床和手术特征,并分析其与短期和长期死亡率、住院时间(LOS)以及30天内再住院的关联。

严重主动脉瓣狭窄的退伍军人经常在VA医疗中心接受TAVR治疗。

纳入2012年至2017年接受TAVR治疗的连续性退伍军人。从VA临床评估、报告和跟踪系统获取患者和手术特征。主要结局为30天和1年生存率、LOS>6天以及30天内再次住院。进行Logistic回归和Cox比例风险分析以评估术前特征与LOS和再入院之间的关联。

研究期间,959名退伍军人在8VA中心接受了TAVR,其中经股动脉入路860名(占90%),经心尖50名(占5%),经腋动脉36名(占3.8%)和经主动脉3名(占0.3%)。绝大部分为男性(939/959[98]),平均年龄78.1岁。30天内有28例死亡(2.9%),1年时死亡134例(14.0%)。LOS的中位数为5天,141名退伍军人在30天内再次住院(14.7%)。非股动脉入路(比值比:1.7495%置信区间[CI]1.102.74)、心力衰竭(比值比:2.5195CI1.833.44)和房颤(比值比:1.4095CI1.011.95)与LOS增加相关。房颤30天内再次住院相关(比值比:1.7995CI1.222.63)。

VA中心接受TAVR治疗的退伍军人主要是老年男性,合并症严重。30天的临床结局、再入院率及1年死亡率优于VA以外的基准结局数据。

原始出处:

Philip S. Hall. Outcomes of Veterans Undergoing TAVR Within Veterans Affairs Medical Centers  Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. JACCCardiovascular Interventions. November 2019.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=950497, encodeId=5f2495049e46, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:58:24 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086380, encodeId=e63f20863803a, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Jul 04 21:14:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854592, encodeId=4e171854592f7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Dec 03 13:14:00 CST 2019, time=2019-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648685, encodeId=53de1648685d9, content=<a href='/topic/show?id=718f9464852' target=_blank style='color:#2F92EE;'>#退伍军人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94648, encryptionId=718f9464852, topicName=退伍军人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4e9d23641338, createdName=smlt2016, createdTime=Wed May 06 01:14:00 CST 2020, time=2020-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326419, encodeId=f7d41326419a8, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Nov 30 06:14:00 CST 2019, time=2019-11-30, status=1, ipAttribution=)]
    2021-03-23 病毒猎手
  2. [GetPortalCommentsPageByObjectIdResponse(id=950497, encodeId=5f2495049e46, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:58:24 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086380, encodeId=e63f20863803a, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Jul 04 21:14:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854592, encodeId=4e171854592f7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Dec 03 13:14:00 CST 2019, time=2019-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648685, encodeId=53de1648685d9, content=<a href='/topic/show?id=718f9464852' target=_blank style='color:#2F92EE;'>#退伍军人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94648, encryptionId=718f9464852, topicName=退伍军人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4e9d23641338, createdName=smlt2016, createdTime=Wed May 06 01:14:00 CST 2020, time=2020-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326419, encodeId=f7d41326419a8, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Nov 30 06:14:00 CST 2019, time=2019-11-30, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=950497, encodeId=5f2495049e46, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:58:24 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086380, encodeId=e63f20863803a, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Jul 04 21:14:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854592, encodeId=4e171854592f7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Dec 03 13:14:00 CST 2019, time=2019-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648685, encodeId=53de1648685d9, content=<a href='/topic/show?id=718f9464852' target=_blank style='color:#2F92EE;'>#退伍军人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94648, encryptionId=718f9464852, topicName=退伍军人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4e9d23641338, createdName=smlt2016, createdTime=Wed May 06 01:14:00 CST 2020, time=2020-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326419, encodeId=f7d41326419a8, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Nov 30 06:14:00 CST 2019, time=2019-11-30, status=1, ipAttribution=)]
    2019-12-03 hbwxf
  4. [GetPortalCommentsPageByObjectIdResponse(id=950497, encodeId=5f2495049e46, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:58:24 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086380, encodeId=e63f20863803a, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Jul 04 21:14:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854592, encodeId=4e171854592f7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Dec 03 13:14:00 CST 2019, time=2019-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648685, encodeId=53de1648685d9, content=<a href='/topic/show?id=718f9464852' target=_blank style='color:#2F92EE;'>#退伍军人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94648, encryptionId=718f9464852, topicName=退伍军人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4e9d23641338, createdName=smlt2016, createdTime=Wed May 06 01:14:00 CST 2020, time=2020-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326419, encodeId=f7d41326419a8, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Nov 30 06:14:00 CST 2019, time=2019-11-30, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=950497, encodeId=5f2495049e46, content=<a href='/topic/show?id=32461e1634a' target=_blank style='color:#2F92EE;'>#TAVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17163, encryptionId=32461e1634a, topicName=TAVR)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211210/ede9c51184aa4f54ae6c1164cfb8eeac/967dbf3eff2943c7bf3ccfec3a776ab0.JPG, createdBy=a33789389, createdName=病毒猎手, createdTime=Tue Mar 23 22:58:24 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2086380, encodeId=e63f20863803a, content=<a href='/topic/show?id=134b304456' target=_blank style='color:#2F92EE;'>#AVR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3044, encryptionId=134b304456, topicName=AVR)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d74253, createdName=wangtianj2007@, createdTime=Sat Jul 04 21:14:00 CST 2020, time=2020-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854592, encodeId=4e171854592f7, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Dec 03 13:14:00 CST 2019, time=2019-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648685, encodeId=53de1648685d9, content=<a href='/topic/show?id=718f9464852' target=_blank style='color:#2F92EE;'>#退伍军人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94648, encryptionId=718f9464852, topicName=退伍军人)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4e9d23641338, createdName=smlt2016, createdTime=Wed May 06 01:14:00 CST 2020, time=2020-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1326419, encodeId=f7d41326419a8, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Nov 30 06:14:00 CST 2019, time=2019-11-30, status=1, ipAttribution=)]

相关资讯

Circulation:经皮冠状动脉介入治疗重度主动脉瓣狭窄和冠状动脉疾病

对于重度主动脉瓣狭窄和冠状动脉疾病患者,完全经皮进行的主动脉瓣置换术和血管重建术与标准的外科手术方法的优劣,尚无对比数据。前瞻性的SURTAVI试验,于2012年6月-2016年6月期间于多个国家的87个中心招募中等风险的重度主动脉瓣狭窄患者,同时排除复杂冠状动脉疾病SYNTAX评分超过22分的患者。根据是否需要进行血管重建将患者分层,随后将患者随机分至经导管主动脉瓣置换术(TAVR)组或手术主动

AHA2019:RECOVERY研究:无症状重度主动脉瓣狭窄患者,早期手术改善生存达8年

目前,有关无症状重度主动脉瓣狭窄患者手术干预的最佳时机仍存争议,AHA 2019最新临床研究专场,Duk-Hyun Kang公布的RECOVERY研究显示,无症状重度主动脉瓣狭窄患者早期手术治疗与观察组相比,可改善生存期达8年。

Circulation:心脏瓣膜病的现代治疗

心脏瓣膜病(VHD)是导致死亡和发病的重要原因,其治疗方法也发生了很大的变化。VHD II调查是由欧洲心脏病学会欧洲观察研究项目设计的,目的是分析VHD的实际管理,并将实践与指南进行比较。2017年,研究人员开展一前瞻性研究,为期3个月,从28个国家共招募了7247位重度VHD或既往进行过瓣膜介入治疗的患者(4483位住院患者、2764位门诊患者)。中位年龄71岁(62-80岁);1917位(26

JACC:未经治疗的中重度主动脉瓣狭窄患者远期生存率低

历史数据显示未接受治疗的主动脉瓣狭窄(AS)患者的生存率低主要局限于严重AS患者。本研究的目的旨在评估所有AS类型患者的预后。本研究纳入分析了测量过主动脉瓣流速和压差的122809名男性患者(平均年龄61±17岁)和118494名女性患者(62±19岁),并排除之前接受过主动脉瓣干预治疗的患者。最终,共有16129名患者(6.7%)、3315名(1.4%)和6383名(2.6%)患者分别为轻度、中

JACC:混合性主动脉瓣疾病接受经导管主动脉瓣置换术的结局

接受TAVR的MAVD患者比单纯AS患者的生存率更高。

JACC:经导管主动脉瓣置换术对右心室-肺动脉耦合的影响

TAVR对LV射血梗阻的直接缓解与RV功能和RV-PA耦合的改善有关。