PDF(Pubmed)
Abstract：
UNASSIGNED: Patients with severe aortic stenosis and cancer are often denied surgical aortic valve replacement (SAVR) due to a prohibitive risk of perioperative mortality.
UNASSIGNED: The purpose of this study was to determine the safety of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis and cancer.
UNASSIGNED: The Nationwide Inpatient Sample database (2002-2018) was used to study the outcomes of TAVI vs SAVR in patients with active or prior history of prostate, lung, colorectal, breast, and renal cancer. A propensity score-matched analysis to calculate adjusted odds ratios (aORs) for major adverse cardiovascular events (MACEs) and its components.
UNASSIGNED: A total of 1,505,995 crude population and a subset of 345,413 noncancer and 33,565 cancer patients were selected on propensity score-matched analysis. The yearly trend showed a steep increase in the utilization of TAVI. Compared with SAVR, TAVI had a lower risk of in-hospital mortality in prostate cancer, while there was no difference among other cancer types. Patients with lung (aOR: 0.65; 95% CI: 0.43-0.97) and prostate cancer (aOR: 0.79; 95% CI: 0.66-0.96) had lower, while colorectal cancer (aOR: 1.43; 95% CI: 1.08-1.90) had higher odds of MACE with TAVI. The incidence of major bleeding was lower with TAVI (except for lung cancer), while the risk of stroke was similar (except for colorectal cancer) between TAVI and SAVR.
UNASSIGNED: TAVI in patients with prostate, breast, lung, and renal cancer appears to be a reasonable alternative to SAVR with lower or similar risks of mortality and MACE.
UNASSIGNED: The purpose of this study was to determine the safety of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis and cancer.
UNASSIGNED: The Nationwide Inpatient Sample database (2002-2018) was used to study the outcomes of TAVI vs SAVR in patients with active or prior history of prostate, lung, colorectal, breast, and renal cancer. A propensity score-matched analysis to calculate adjusted odds ratios (aORs) for major adverse cardiovascular events (MACEs) and its components.
UNASSIGNED: A total of 1,505,995 crude population and a subset of 345,413 noncancer and 33,565 cancer patients were selected on propensity score-matched analysis. The yearly trend showed a steep increase in the utilization of TAVI. Compared with SAVR, TAVI had a lower risk of in-hospital mortality in prostate cancer, while there was no difference among other cancer types. Patients with lung (aOR: 0.65; 95% CI: 0.43-0.97) and prostate cancer (aOR: 0.79; 95% CI: 0.66-0.96) had lower, while colorectal cancer (aOR: 1.43; 95% CI: 1.08-1.90) had higher odds of MACE with TAVI. The incidence of major bleeding was lower with TAVI (except for lung cancer), while the risk of stroke was similar (except for colorectal cancer) between TAVI and SAVR.
UNASSIGNED: TAVI in patients with prostate, breast, lung, and renal cancer appears to be a reasonable alternative to SAVR with lower or similar risks of mortality and MACE.
摘要：
■患有严重主动脉瓣狭窄和癌症的患者通常被拒绝手术主动脉瓣置换术（SAVR），因为围手术期死亡的风险过高。
■本研究的目的是确定严重主动脉瓣狭窄和癌症患者经导管主动脉瓣植入（TAVI）的安全性。
■全国住院患者样本数据库（2002-2018）用于研究具有活动性或先前前列腺病史的患者的TAVI与SAVR的结果，肺，结直肠,乳房,和肾癌。倾向评分匹配分析，以计算主要不良心血管事件（MACE）及其组成部分的调整比值比（aOR）。
■共有1,505,995名粗人群和345,413名非癌症患者和33,565名癌症患者进行倾向评分匹配分析。年趋势显示，TAVI的利用率急剧增加。与SAVR相比,TAVI在前列腺癌中住院死亡的风险较低，而其他癌症类型之间没有差异。肺癌(aOR:0.65;95%CI:0.43-0.97)和前列腺癌(aOR:0.79;95%CI:0.66-0.96)而结直肠癌(aOR:1.43;95%CI:1.08-1.90)与TAVI发生MACE的几率更高。TAVI的大出血发生率较低（肺癌除外），而TAVI和SAVR的卒中风险相似(结直肠癌除外).
■前列腺患者的TAVI，乳房,肺，肾癌似乎是SAVR的合理替代方案,死亡率和MACE风险较低或相似.
■本研究的目的是确定严重主动脉瓣狭窄和癌症患者经导管主动脉瓣植入（TAVI）的安全性。
■全国住院患者样本数据库（2002-2018）用于研究具有活动性或先前前列腺病史的患者的TAVI与SAVR的结果，肺，结直肠,乳房,和肾癌。倾向评分匹配分析，以计算主要不良心血管事件（MACE）及其组成部分的调整比值比（aOR）。
■共有1,505,995名粗人群和345,413名非癌症患者和33,565名癌症患者进行倾向评分匹配分析。年趋势显示，TAVI的利用率急剧增加。与SAVR相比,TAVI在前列腺癌中住院死亡的风险较低，而其他癌症类型之间没有差异。肺癌(aOR:0.65;95%CI:0.43-0.97)和前列腺癌(aOR:0.79;95%CI:0.66-0.96)而结直肠癌(aOR:1.43;95%CI:1.08-1.90)与TAVI发生MACE的几率更高。TAVI的大出血发生率较低（肺癌除外），而TAVI和SAVR的卒中风险相似(结直肠癌除外).
■前列腺患者的TAVI，乳房,肺，肾癌似乎是SAVR的合理替代方案,死亡率和MACE风险较低或相似.
