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Abstract：
BACKGROUND: Anemia is associated with worse clinical outcomes in cardiac patients. We aim to investigate the clinical outcomes and readmission rates in anemic patients undergoing transcatheter edge-to-edge repair (TEER) for severe mitral valve regurgitation (MR).
METHODS: The National Readmissions Database (NRD) from 2015 to 2018 was queried using the ICD-10 codes to identify patients admitted for TEER. Patients were divided into anemic and non-anemic sub-groups. Univariate and multivariate analyses were performed. Cardiovascular outcomes were assessed between cohorts at index admission and readmissions at 30, 90, and 180 days. STATA v.17 was used for analysis (StataCorp LLC, Texas, USA).
RESULTS: Our final cohort included 28,995 patients who had undergone TEER in the United States between 2016 and 2019. About 1,434 (4.9%) had a diagnosis of anemia. The mean age of patients who had TEER with anemia and TEER without anemia was 76.9 ± 10.8 vs. 77.7 ± 10.2, respectively. In the adjusted model, anemic patients had higher odds of acute kidney injury (AKI) (aOR 2.21; 95% [CI 1.81-2.6; p<0.001]), HF (aOR 1.75; 95% [CI 1.28-2.3; p<0.001]), myocardial infarction (MI) (aOR 1.54; 95% [CI 1.01-2.33; p<0.041]), major adverse cardiac and cerebrovascular events (MACCE) (aOR 1.72; 95% [CI 1.2-9-2.3; p<0.001]), and net adverse event (aOR 1.85; 95% [CI 1.32-2.59; p<0.001]). The anemic group\'s readmission rate was overall higher at 30, 90, and 180 days from 2016 to 2019.
CONCLUSIONS: Anemia was associated with increased adverse clinical outcomes and more extended hospital stays in patients with anemia who had undergone TEER procedures compared to the non-anemic group.
METHODS: The National Readmissions Database (NRD) from 2015 to 2018 was queried using the ICD-10 codes to identify patients admitted for TEER. Patients were divided into anemic and non-anemic sub-groups. Univariate and multivariate analyses were performed. Cardiovascular outcomes were assessed between cohorts at index admission and readmissions at 30, 90, and 180 days. STATA v.17 was used for analysis (StataCorp LLC, Texas, USA).
RESULTS: Our final cohort included 28,995 patients who had undergone TEER in the United States between 2016 and 2019. About 1,434 (4.9%) had a diagnosis of anemia. The mean age of patients who had TEER with anemia and TEER without anemia was 76.9 ± 10.8 vs. 77.7 ± 10.2, respectively. In the adjusted model, anemic patients had higher odds of acute kidney injury (AKI) (aOR 2.21; 95% [CI 1.81-2.6; p<0.001]), HF (aOR 1.75; 95% [CI 1.28-2.3; p<0.001]), myocardial infarction (MI) (aOR 1.54; 95% [CI 1.01-2.33; p<0.041]), major adverse cardiac and cerebrovascular events (MACCE) (aOR 1.72; 95% [CI 1.2-9-2.3; p<0.001]), and net adverse event (aOR 1.85; 95% [CI 1.32-2.59; p<0.001]). The anemic group\'s readmission rate was overall higher at 30, 90, and 180 days from 2016 to 2019.
CONCLUSIONS: Anemia was associated with increased adverse clinical outcomes and more extended hospital stays in patients with anemia who had undergone TEER procedures compared to the non-anemic group.
摘要：
背景：在心脏病患者中，贫血与较差的临床预后相关。我们的目的是调查经导管边缘到边缘修复（TEER）治疗严重二尖瓣反流（MR）的贫血患者的临床结果和再入院率。
方法：使用ICD-10代码查询了2015年至2018年的国家再入院数据库（NRD），以识别接受TEER的患者。患者分为贫血和非贫血亚组。进行单变量和多变量分析。在初次入院和30、90和180天再次入院时评估队列之间的心血管结局。STATAv.17用于分析(StataCorpLLC，德州,美国）。
结果：我们的最终队列包括2016年至2019年在美国接受TEER的28,995名患者。大约1,434（4.9％）被诊断为贫血。TEER伴贫血和TEER不伴贫血患者的平均年龄为76.9±10.8。分别为77.7±10.2。在调整后的模型中，贫血患者出现急性肾损伤(AKI)的几率较高(aOR2.21;95%[CI1.81-2.6;p<0.001]),HF（aOR1.75；95%[CI1.28-2.3；p<0.001]），心肌梗死（MI）（aOR1.54；95%[CI1.01-2.33；p<0.041]），主要不良心脑血管事件（MACCE）（aOR1.72；95%[CI1.2-9-2.3；p<0.001]），和净不良事件（aOR1.85；95%[CI1.32-2.59；p<0.001]）。从2016年到2019年，贫血组的再入院率在30、90和180天总体较高。
结论：与非贫血组相比，接受TEER手术的贫血患者的贫血与不良临床结局增加和住院时间延长相关。
方法：使用ICD-10代码查询了2015年至2018年的国家再入院数据库（NRD），以识别接受TEER的患者。患者分为贫血和非贫血亚组。进行单变量和多变量分析。在初次入院和30、90和180天再次入院时评估队列之间的心血管结局。STATAv.17用于分析(StataCorpLLC，德州,美国）。
结果：我们的最终队列包括2016年至2019年在美国接受TEER的28,995名患者。大约1,434（4.9％）被诊断为贫血。TEER伴贫血和TEER不伴贫血患者的平均年龄为76.9±10.8。分别为77.7±10.2。在调整后的模型中，贫血患者出现急性肾损伤(AKI)的几率较高(aOR2.21;95%[CI1.81-2.6;p<0.001]),HF（aOR1.75；95%[CI1.28-2.3；p<0.001]），心肌梗死（MI）（aOR1.54；95%[CI1.01-2.33；p<0.041]），主要不良心脑血管事件（MACCE）（aOR1.72；95%[CI1.2-9-2.3；p<0.001]），和净不良事件（aOR1.85；95%[CI1.32-2.59；p<0.001]）。从2016年到2019年，贫血组的再入院率在30、90和180天总体较高。
结论：与非贫血组相比，接受TEER手术的贫血患者的贫血与不良临床结局增加和住院时间延长相关。
