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- W4386269791 abstract "Introduction and objectives: To evaluate the prevalence, clinical characteristics, and outcomes of patients with angina undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. Methods: A total of 1687 consecutive patients with severe aortic stenosis undergoing TAVR at our center were prospectively included and classified according to patient-reported angina symptoms prior to the TAVR procedure. Baseline, procedural and follow-up data were collected in a dedicated database. Results: A total of 497 patients (29%) had angina prior to the TAVR procedure. Patients with angina at baseline showed a worse New York Heart Association (NYHA) functional class (NYHA class > II: 69% vs 63%; P = .017), a higher rate of coronary artery disease (74% vs 56%; P < .001), and a lower rate of complete revascularization (70% vs 79%; P < .001). Angina at baseline had no impact on all-cause mortality (HR, 1.02; 95%CI, 0.71-1.48; P = .898) and cardiovascular mortality (HR, 1.2; 95%CI, 0.69-2.11; P = .517) at 1 year. However, persistent angina at 30 days post-TAVR was associated with increased all-cause mortality (HR, 4.86; 95%CI, 1.71-13.8; P = .003) and cardiovascular mortality (HR, 20.7; 95%CI, 3.50-122.6; P = .001) at 1-year follow-up. Conclusions: More than one-fourth of patients with severe aortic stenosis undergoing TAVR had angina prior to the procedure. Angina at baseline did not appear to be a sign of a more advanced valvular disease and had no prognostic impact; however, persistent angina at 30 days post-TAVR was associated with worse clinical outcomes. Introducción y objetivos: Evaluar la prevalencia, las características clínicas y el impacto de la angina en pacientes con estenosis aórtica sometidos a implante percutáneo de válvula aórtica (TAVI). Métodos: Se analizó a 1.687 pacientes consecutivos con estenosis aórtica sometidos a TAVI, clasificados en función de la presencia o ausencia basal de angina. Los datos basales, del procedimiento y del seguimiento se recogieron en una base de datos local. Resultados: Un total de 497 pacientes (29%) presentaban angina antes del TAVI. Los pacientes con angina basal presentaban peor clase funcional (NYHA > II, el 69 frente al 63%; p = 0,017) y una mayor prevalencia de enfermedad coronaria (el 74 frente al 56%; p < 0,001). La angina basal no mostró impacto pronóstico a 1 año en mortalidad por cualquier causa (HR = 1,02; IC95%, 0,71-1,48; p = 0,898) ni en mortalidad cardiovascular (HR = 1,2; IC95%, 0,69-2,11; p = 0,517). Sin embargo, la persistencia de angina 30 días después del procedimiento se asoció con un incremento en la mortalidad a 1 año, tanto total (HR = 4,86; IC95%, 1,71-13,8; p = 0,003) como de causa cardiovascular (HR = 20,7; IC95%, 3,50-122,6; p = 0,001). Conclusiones: Más de un cuarto de los pacientes con estenosis aórtica sometidos a TAVI tenían angina antes del procedimiento. La angina basal no mostró impacto pronóstico alguno. Sin embargo, la persistencia de angina 30 días después del procedimiento se asoció con una mayor mortalidad al año." @default.
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- W4386269791 date "2023-08-01" @default.
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- W4386269791 title "Angina en pacientes con estenosis aórtica grave sometidos a implante percutáneo de la válvula aórtica" @default.
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- W4386269791 doi "https://doi.org/10.1016/j.recesp.2023.04.001" @default.
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