Key result
Active cancer in patients undergoing TAVR was not associated with increased in-hospital mortality (aOR 1.06; 95% CI 0.89-1.27; P=0.523) but was linked to higher readmission and bleeding risks.
Why the study?
Data on clinical outcomes after TAVR in specific cancer types or in the presence of metastatic disease remained sparse.
Does the presence of active cancer affect in-hospital mortality, complications, and readmission rates in patients undergoing TAVR?
Observational (n=122,573)
Yes
Does the presence of active cancer affect in-hospital mortality, complications, and readmission rates in patients undergoing TAVR?
Patients with active cancer undergoing TAVR have similar in-hospital mortality compared to those without cancer, but face higher risks of readmission and bleeding complications.
Should not yet alter TAVR decisions for active cancer; leaves open need for prospective studies on complications.
Background Data on clinical outcomes after transcatheter aortic valve replacement (TAVR) in specific cancer types or the presence of metastatic disease remain sparse. This study aimed to investigate the impact of active cancer on short‐term mortality, complications, and readmission rates after TAVR across different cancer types. Methods and Results The authors assessed the Nationwide Readmissions Database for TAVR cases from 2012 to 2019. Patients were stratified by specific cancer types. Primary outcome was in‐hospital mortality. Secondary outcomes included bleeding requiring blood transfusion and readmissions at 30, 90, and 180 days after TAVR. Overall, 122 573 patients undergoing TAVR were included in the analysis, of whom 8013 (6.5%) had active cancer. After adjusting for potential confounders, the presence of active cancer was not associated with increased in‐hospital mortality (adjusted odds ratio [aOR], 1.06 [95% CI, 0.89–1.27]; P =0.523). However, active cancer was associated with an increased risk of readmission at 30, 90, and 180 days after TAVR and increased risk of bleeding requiring transfusion at 30 days. Active colon and any type of metastatic cancer were individually associated with readmissions at 30, 90, and 180 days after TAVR. At 30 days after TAVR, colon (aOR, 2.51 [95% CI, 1.68–3.76]; P <0.001), prostate (aOR, 1.40 [95% CI, 1.05–1.86]; P =0.021), and any type of metastatic cancer (aOR, 1.65 [95% CI, 1.23–2.22]; P =0.001) were individually associated with an increased risk of bleeding requiring transfusion. Conclusions Patients with active cancer had similar in‐hospital mortality after TAVR but higher risk of readmission and bleeding requiring transfusion, the latter depending on certain types of cancer.
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Aikawa et al. (2023) conducted an observational in Transcatheter Aortic Valve Replacement (TAVR) (n=122,573). Active cancer vs. Without active cancer was evaluated on In-hospital mortality (aOR 1.06, 95% CI 0.89-1.27, p=0.523). Active cancer in patients undergoing TAVR was not associated with increased in-hospital mortality (aOR 1.06; 95% CI 0.89-1.27; P=0.523) but was linked to higher readmission and bleeding risks.
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