Hemodialysis in patients undergoing TAVI was associated with higher 1-year all-cause death compared to non-hemodialysis (14.4% vs. 6.5%), though this was not significant after adjustment.
Cohort (n=2,888)
Yes
Does hemodialysis worsen all-cause mortality in patients undergoing contemporary transcatheter aortic valve implantation?
In patients undergoing contemporary TAVI, hemodialysis is associated with higher unadjusted mortality, but this is driven by baseline comorbidities rather than hemodialysis itself.
Absolute Event Rate: 14.4% vs 6.5%
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement in hemodialysis patients; however, contemporary outcomes and risk stratifications remain unreported. METHODS AND RESULTS: Using data from a multicenter database, this study included 2,888 patients who underwent TAVI between 2021 and 2024: 336 (11.6%) on hemodialysis and 2,552 (88.4%) not. The primary outcome was all-cause death after TAVI; the median follow-up was 527 days. Hemodialysis patients were younger, predominantly male, and had more comorbidities with higher surgical risk. Hemodialysis and non-hemodialysis patients had similar 30-day mortality (2.9% vs. 1.5%, respectively) and major procedural complications. Hemodialysis patients had 2- to 3-fold higher rates of all-cause death (14.4% vs. 6.5% at 1-year; 21.5% vs. 11.0% at 2 years), cardiovascular death, and the composite of all-cause death and heart failure hospitalization. After adjusting for confounders, hemodialysis had no significant effect on all-cause death and the composite endpoint. Body mass index, Clinical Frailty Scale, and albumin levels were associated with all-cause death in hemodialysis patients, allowing risk stratification into low-, intermediate-, and high-risk groups. CONCLUSIONS: In this study, hemodialysis patients were younger and had more comorbidities, but 30-day mortality and complications were similar to the non-hemodialysis group. Although hemodialysis patients had higher all-cause mortality, the worse outcomes in this group were attributed to comorbidities rather than the hemodialysis itself.
Higuchi et al. (Fri,) conducted a cohort in Patients undergoing Transcatheter Aortic Valve Implantation (TAVI) (n=2,888). Hemodialysis vs. Non-hemodialysis was evaluated on All-cause death after TAVI. Hemodialysis in patients undergoing TAVI was associated with higher 1-year all-cause death compared to non-hemodialysis (14.4% vs. 6.5%), though this was not significant after adjustment.