E-2 | Prevalence and Clinical Correlates of Obstructive Sleep Apnea on In-hospital Outcomes following Transcatheter Aortic Valve Replacement: Results from National Inpatient Sample Database 2016-2020

Obstructive sleep apnea (OSA) is associated with increased perioperative risks following major cardiac surgeries. Insufficient contemporary data exists assessing the impact of OSA on clinical outcomes post-transcatheter aortic valve replacement (TAVR). Patients undergoing TAVR were identified from the National Inpatient Sample Database. A matched analysis was performed, accounting for co-morbidities and demographic variables, to assess the association between obstructive sleep apnea (OSA) and in-hospital outcomes utilizing multivariate logistic regression. 254,105 patients underwent TAVR between 2016 - 2020. Among them, 42,485 (14.3%) patients were found to have OSA. After multivariate adjustment in a matched population of 7,225 patients in each cohort, the presence of OSA was associated with higher rates of permanent pacemaker (PPM) implantation (aOR 1.122; CI: 1.007 - 1.251), complete heart block (aOR 1.205; CI: 1.007 - 1.348), and major bleeding (aOR 1.231; CI: 1.029 - 1.473). No association of OSA was noted with other studied variables including in-hospital mortality, acute myocardial infarction, ischemic stroke, or acute kidney injury. OSA is common in patients undergoing TAVR and is associated with higher rates of requirement for pacemaker implantation, complete heart block and major bleeding. All other assessed outcomes revealed no significant association. Additional research is warranted to evaluate the potential effectiveness of preventive and therapeutic interventions in mitigating this identified risk.