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Transcatheter aortic valve implantation (TAVI) has revolutionized the management of aortic stenosis (AS) in the last 2 decades. However, with worsening stenosis, the patient develops diastolic dysfunction the large majority (N: 231,497; 72.3%) had co-existing HF. After propensity matching (N=126,528), HF patients were found to have higher in-hospital mortality (1.6% vs 1.2%, aOR:1.36) acute myocardial infarction (4.5% vs 1.9%, aOR:2.3), sudden cardiac arrest (1% vs 0.7%, aOR:1.14), cardiogenic shock (2.4% vs 0.8%, aOR: 2.8), mechanical circulatory support (1% vs 0.4%, aOR:2.18) peri-procedural mortality of TAVR has decreased from 1.6% to 1.2% (p-trend:0.006) Patients with HF also have longer LOS and resource utilization (p<0.05). In severe Aortic stenosis, the development of HF is a strong predictor of higher mortality and worse clinical outcomes after TAVI implantation.
Kumar et al. (Wed,) studied this question.
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