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18.02.2020 | Original Paper

Prognostic impact of cancer history in patients undergoing transcatheter aortic valve implantation

verfasst von: Noriaki Tabata, Baravan Al-Kassou, Atsushi Sugiura, Julian Kandt, Jasmin Shamekhi, Anja Stundl, Sebastian Zimmer, Hendrik Treede, Masanobu Ishii, Kenichi Tsujita, Georg Nickenig, Nikos Werner, Jan-Malte Sinning

Erschienen in: Clinical Research in Cardiology | Ausgabe 10/2020

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Abstract

Background

The benefit of TAVI in cancer patients is currently unclear.

Objectives

The purpose of this study is to investigate prognostic impact of cancer status (active cancer or previous cancer) in severe aortic stenosis (AS) patients undergoing transcatheter aortic valve implantation (TAVI).

Methods

Consecutive TAVI patients in the Heart Center Bonn were enrolled and we stratified the patients into three groups: current cancer (active cancer), non-current cancer (previous cancer), or no cancer. The primary outcome was all-cause death within a 5-year follow-up. We evaluated mean aortic pressure gradient (mPG) values following TAVI (baseline mPG) and at the final follow-up (follow-up mPG).

Results

In total, 1568 TAVI patients were eligible and 298 patients (19.0%) had active or previous cancer. At the 5-year follow-up, cancer patients had a significantly worse prognosis than non-cancer patients (log rank, P < 0.001). In a multivariable analysis, previous cancer was a significant predictor for 5-year mortality (hazard ratio [HR], 1.56; P < 0.001). Estimated mortality rates at 5-year follow-up rates among active cancer, previous cancer, and non-cancer were 84.0%, 65.8%, and 50.2% (long-rank P < 0.001), respectively. The hazard ratios of active cancer and previous cancer for 5-year mortality were 2.79 (P < 0.001) and 1.38 (P = 0.019) compared to non-cancer patients. We found significantly higher mPG during follow-up than at baseline in cancer patients (follow-up 8.10 vs baseline 7.40 mmHg; Wilcoxon P = 0.012).

Conclusions

Active, and also previous, cancer status are associated with less beneficial long-term prognosis in TAVI patients.

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Titel: Prognostic impact of cancer history in patients undergoing transcatheter aortic valve implantation
verfasst von: Noriaki Tabata
Baravan Al-Kassou
Atsushi Sugiura
Julian Kandt
Jasmin Shamekhi
Anja Stundl
Sebastian Zimmer
Hendrik Treede
Masanobu Ishii
Kenichi Tsujita
Georg Nickenig
Nikos Werner
Jan-Malte Sinning
Publikationsdatum: 18.02.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 10/2020
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-020-01615-y

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Abstract

Background

Objectives

Methods

Results

Conclusions

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