E-51 | Impact of anemia on in-hospital outcomes among patients with coronary artery disease hospitalized for Transcatheter Aortic Valve Replacement (TAVR) : Insight from the NIS registry 2020

Recent studies demonstrated the association between baseline anemia and adverse clinical outcomes in patients undergoing transcatheter aortic valve replacement (TAVR), such as heightened in-hospital mortality, acute renal failure within 30 days, and the need for blood transfusions. Nevertheless, the impact of anemia on patients with coronary artery disease (CAD) undergoing TAVR remains uncertain. We examined the 2020 U.S. National Inpatient Sample (NIS) to study the impact of anemia on CAD patients undergoing TAVR. Participants aged 18 and above were identified using relevant ICD-10 CM and PCS codes. Multivariable logistic and linear regression analyses were conducted to calculate adjusted odds ratios (aORs) for the specified outcomes. We identified 49,920 CAD patients that were undergoing TAVR, with a mean age of 78±8 years; 33.5% were female. Caucasians accounted for 88%, followed by Blacks (3%), Mexican Americans (5%), and Asians (1%). Of these, 27.2% (13,590/49,920) had a concurrent diagnosis of anemia. In a survey multivariable regression model adjusting for confounding factor, anemia was significantly associated with prolonged length of hospital stay (β 2.00, 95% CI: 1.81, 2.20, p <0.001), increased risk of acute kidney injury (aOR 2.69, 95% CI: 2.29, 3.16, p <0.001), deep vein thrombosis (aOR 2.71, 95% CI: 1.13, 6.51, p 0.026), mechanical ventilation use (aOR 2.31, 95% CI: 1.65, 3.21, p <0.001), respiratory failure (aOR 2.53, 95% CI: 2.01, 3.18, p <0.001), and cardiogenic shock (aOR 3.54, 95% CI: 2.59, 4.84, p <0.001). Additionally, there was a high likelihood of pulmonary embolism (aOR 2.77, 95% CI: 0.95, 8.12, p 0.063) and pacemaker implantation (aOR 1.17, 95% CI: 0.99, 1.39, p 0.060) without statistical significance. No significant increase in the risk of in-hospital mortality and sepsis was observed among anemia vs. non-anemia patients. Our study found that anemia among hospitalized CAD patients undergoing TAVR is associated with prolonged length of hospital stay and increased risks of in-hospital AKI, DVT, mechanical ventilation, respiratory failure, and cardiogenic shock. Further longitudinal cohort studies are needed for a more comprehensive understanding of this association.