E-21 | Do Underlying Autoimmune Disorders Increase Risk of Post-TAVR Complications? An Outcome Analysis

Patients with autoimmune diseases (ADs) are at increased risk of aortic stenosis but studies on management of these patients with transcatheter aortic valve replacement (TAVR) are limited. We aimed to study compared the complications of TAVR in ADs including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis. A retrospective cohort analysis was conducted using National Inpatient Sample 2016-2020. TAVR patients were divided into those with and without underlying ADs. Post-TAVR outcomes include mortality, heart blocks, intra/postoperative stroke, intra/postoperative bleeding, acute kidney injury (AKI), and mechanical complications of the valve (MCV) including leakage, displacement, and breakdown. Among 296740 patients who underwent TAVR, RA had highest prevalence (0.23%, n=7775), followed by SLE (0.36%, n=1065), and SS (0.23%, n=670). Underlying RA in TAVR patients was associated with higher odds of intra/post-operative bleeding (OR 1.26, CI 0.75-2.09, p=0.03), but there was no association with mortality (OR 0.75, CI 0.46-1.22, p=0.25), heart blocks (OR 1.08, CI 0.97-1.2, p=0.17), intra/post-operative stroke (OR 1.26, CI 0.75-2.09, p=0.38), AKI (OR 0.84, CI 0.69-1.01, p=0.07), and MCV (OR 0.43, CI 0.17-1.03, p=0.06). Additionally, underlying SLE and SS were not associated with higher risk of post-TAVR complications (Table 1). Underlying RA is associated with higher risk of intra/post-operative bleeding in patients undergoing TAVR. While, underlying SLE and SS are not associated with increased risk of post-TAVR complications.