Inflammatory bowel disease in patients undergoing TAVR was associated with a higher 1-year risk of all-cause mortality compared to non-IBD patients (RR 1.45; 95% CI 1.34-1.56; p<0.0001).
Cohort (n=103,372)
Yes
Does the presence of inflammatory bowel disease increase the risk of adverse outcomes in adults undergoing transcatheter aortic valve replacement?
Inflammatory bowel disease is associated with significantly increased 1-year mortality and peri-procedural complications following TAVR, highlighting the need for tailored peri-procedural management in this vulnerable population.
Effect estimate: RR 1.45 (95% CI 1.34-1.56)
p-value: p=<0.0001
Background: Inflammatory bowel disease (IBD) is associated with inflammation and altered hemostatic and immune responses, which may increase thrombotic and infectious risks that could influence TAVR outcomes.We compared clinical outcomes after TAVR in patients with and without IBD using a multi-institutional EHR Methods: Using TriNetX for this retrospective cohort study, we identified adults aged 18 who underwent TAVR from Jan 2010 to Jan 2025.Patients were stratified into two cohorts based on the presence or absence of IBD using ICD-10/CPT codes.Propensity score matching (PSM) was performed based on age, sex, ethnicity, DM, HTN, HF, and CKD to achieve balanced cohorts (Table 1) Results: A total of 103372 adult patients who underwent TAVR were included in this study, with PSM cohorts comprising 9718 patients.At 1 year, IBD patients who underwent TAVR had a significantly higher risk of all-cause mortality (RR 1.45, 95% CI 1.34-1.56,p<0.0001),PVL (RR 1.76, 95% CI 1.01-3.05,p=0.0403),AMI (RR 1.37, 95% CI 1.20-1.58,p<0.0001), septic shock (RR 1.62, 95% CI 1.42-1.85,p<0.0001), and MCS use (RR 2.63, 95% CI 1.31-5.27,p=0.0044) (Table 2).No statistically significant differences were observed in the incidence of aortic dissection, hemorrhagic stroke, and readmission Conclusions: Our study shows that IBD patients undergoing TAVR are associated with increased mortality, PVL, AMI, septic shock, mechanical ventilation, ischemic stroke and MCS use compared with non-IBD patients, suggesting chronic inflammation and related treatments may contribute to an added vulnerability, emphasizing peri-procedural management strategies to improve outcomes in this cohort
Afridi et al. (Wed,) conducted a cohort in Transcatheter Aortic Valve Replacement (TAVR) (n=103,372). Inflammatory Bowel Disease (IBD) vs. No Inflammatory Bowel Disease was evaluated on All-cause mortality (RR 1.45, 95% CI 1.34-1.56, p=<0.0001). Inflammatory bowel disease in patients undergoing TAVR was associated with a higher 1-year risk of all-cause mortality compared to non-IBD patients (RR 1.45; 95% CI 1.34-1.56; p<0.0001).
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