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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
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01. History of Cardiology
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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32. Cardiovascular Nursing
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Event free survival after TAVI: A study on clinical and CT pre-procedural characteristics
Session:
Posters 1 - Écran 6 - Cardiologia de Intervenção
Speaker:
Afonso Félix Oliveira
Congress:
CPC 2019
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters
FP Number:
---
Authors:
Afonso Félix De Oliveira; Rui Campante Teles; António Miguel Ferreira; João Brito; Henrique Gabriel; Pedro de Araújo Gonçalves; Luís Raposo ; Tiago Nolasco; Gonçalo Lopes Da Cunha; João Abecasis; Carla Rodrigues Carvalho; Manuel Almeida; Miguel Mendes
Abstract
<p><strong>Introduction: </strong>Predictors of short-term mortality and morbidity in patients with severe aortic stenosis have been described in both TAVI and surgical cohorts. In contrast, the characteristics associated with favorable response and long-term survival free of adverse events are not fully characterized.</p> <p><strong>Methods: </strong>We performed a retrospective cohort analysis of TAVI patients between Jan/2016 and Ago-2018 in a single center, including 194 consecutive patients (105 women, mean age 83 ± 6 years, mean EuroScore II 6.1 ± 4.2). The most common diagnosis was degenerative aortic valve disease (90.7%) and the main access route was transfemoral (93.8%). CT images were studied with dedicated software to evaluate fat composition at L3 level. The Total Vascular Calcium Score (TCS) quantified the calcification in the aorta and ileofemoral vessels using a modified Agatston score adjusted for luminal attenuation in contrasted-CT images. Our primary endpoint was event free survival defined as time to heart failure hospitalization, myocardial infarction, stroke, bleeding or death.</p> <p><strong>Results: </strong>Mortality was 9.3% at 1st year, 11.9% at 2 years and 12,9% at follow-up (16.2 ± 9.3 months). Event free survival was 83.5% at 1 year and 79.4% at 2 years. By univariate analysis, the ESII (HR 1.09; 1.03-1.15), glomerular filtration rate (HR 0.97; 0.059-0.096), plasma albumin (HR 0.6; 0.37-1.00), NT-proBNP (HR 1.05 ; 1.02-1.09) and the TCS (HR 1.015 ; 1.001-1.030) were associated with event free survival. Differently, the body mass index, haemoglobin, age and fat composition analysis at vertebral L3 level - body circumference and area of visceral and subcutaneous fat - were not associated with event free survival. By multivariate analysis, only ESII remained as an independent predictor of event free survival ( p < 0.05).</p> <p><strong>Conclusions: </strong>Contemporary TAVI patients present a favorable prognosis after intervention and EuroScore II emerges as the only independent predictor of event free survival.</p>
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