RESULTS: From a prospective registry, consecutive patients with TAVI were included. Baseline clinic and imaging data (echocardiographic and computed tomography) were analyzed. Long-term (up to 5 years) clinical and echocardiographic outcomes were studied. Of 1000 consecutive patients (mean age 81±6 years, 46% female), 107 (11%) had CID; the most frequent entities included polymyalgia rheumatica (31%) and rheumatoid arthritis (28%). Patients with CID were predominantly female (60% versus 44%, P=0.002) and more often had pulmonary disorders (21% versus 13%, P=0.046) and atrial fibrillation (32% versus 20%, P=0.003). The presence of CID was associated with a higher rate of postinterventional infection (5% versus 1%, P=0.007) and further emerged as a risk factor for rehospitalization for bleeding or infection (hazard ratio, 1.93 and 1.62, respectively). Premature valve degeneration, endocarditis, and all-cause mortality were not increased among patients with CID.
CONCLUSIONS: This real-world analysis found that patients with CID undergoing TAVI were associated with a higher risk of postinterventional infectious complications and rehospitalization due to infection. However, valve durability and survival seem not to differ between patients with TAVI with versus without CID.
结果:从前瞻性注册表中,纳入了连续的TAVI患者.分析了基线临床和影像学数据(超声心动图和计算机断层扫描)。研究了长期(长达5年)临床和超声心动图结果。在1000名连续患者中(平均年龄81±6岁,46%女性),107(11%)有CID;最常见的实体包括风湿性多肌痛(31%)和类风湿性关节炎(28%)。CID患者以女性为主(60%对44%,P=0.002)和更常见的肺部疾病(21%对13%,P=0.046)和心房颤动(32%对20%,P=0.003)。CID的存在与较高的介入后感染率相关(5%对1%,P=0.007),并进一步成为出血或感染再住院的危险因素(风险比,分别为1.93和1.62)。瓣膜过早变性,心内膜炎,CID患者的全因死亡率没有增加
结论:这项实际分析发现,接受TAVI的CID患者与介入后感染并发症和因感染而再次住院的风险较高相关。然而,TAVI患者的瓣膜耐久性和生存率似乎没有差异。