Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer

Yusuke Watanabe, Ken Kozuma, Hirofumi Hioki, Hideyuki Kawashima, Yugo Nara, Akihisa Kataoka, Shinichi Shirai, Norio Tada, Motoharu Araki, Kensuke Takagi, Futoshi Yamanaka, Masanori Yamamoto, Kentaro Hayashida

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

The aim of this study was to evaluate postprocedural and midterm outcomes of transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis and active cancer. From October 2013 to August 2015, a total of 749 patients undergoing TAVI using the Edwards Sapien XT prosthesis (Edwards Lifesciences, Irvine, California) were prospectively included in the OCEAN-TAVI registry from 8 Japanese centers. A total of 47 patients (44.7% men; median age 83 years) had active cancer. The transfemoral approach was implemented in 85.1% of patients in the cancer group and 78.1% in the noncancer group (p = 0.22). The occurrence of major vascular complication (4.3% vs 7.5%, p = 0.24), life-threatening bleeding (2.1% vs 7.1%, p = 0.15), and major bleeding (8.5% vs 13%, p = 0.38) was similar between the cancer and noncancer groups. No significant differences were observed regarding device success (100% vs 96.2%, p = 0.17) or 30-day survival (95.7% vs 97.3%, p = 0.38). No difference in midterm survival was found between the patients with cancer and without cancer (log-rank, p = 0.42), regardless of advanced or limited cancer (log-rank, p = 0.68). In a multivariable Cox proportional hazard regression analysis, cancer metastasis was one of the most significant predictors of late mortality (hazard ratio 4.73, 95% CI 1.12 to 20.0; p = 0.035). In conclusion, patients with cancer with severe aortic stenosis who underwent TAVI had similar acute outcomes and midterm survival rates compared with patients without cancer. Cancer metastasis was associated with increased mortality after TAVI.

Original languageEnglish
Pages (from-to)572-577
Number of pages6
JournalAmerican Journal of Cardiology
Volume118
Issue number4
DOIs
Publication statusPublished - 2016 Aug 15

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Neoplasms
Aortic Valve Stenosis
Transcatheter Aortic Valve Replacement
Hemorrhage
Neoplasm Metastasis
Survival
Mortality
Prostheses and Implants
Blood Vessels
Registries
Survival Rate
Regression Analysis
Equipment and Supplies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer. / Watanabe, Yusuke; Kozuma, Ken; Hioki, Hirofumi; Kawashima, Hideyuki; Nara, Yugo; Kataoka, Akihisa; Shirai, Shinichi; Tada, Norio; Araki, Motoharu; Takagi, Kensuke; Yamanaka, Futoshi; Yamamoto, Masanori; Hayashida, Kentaro.

In: American Journal of Cardiology, Vol. 118, No. 4, 15.08.2016, p. 572-577.

Research output: Contribution to journalArticle

Watanabe, Y, Kozuma, K, Hioki, H, Kawashima, H, Nara, Y, Kataoka, A, Shirai, S, Tada, N, Araki, M, Takagi, K, Yamanaka, F, Yamamoto, M & Hayashida, K 2016, 'Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer', American Journal of Cardiology, vol. 118, no. 4, pp. 572-577. https://doi.org/10.1016/j.amjcard.2016.05.052
Watanabe, Yusuke ; Kozuma, Ken ; Hioki, Hirofumi ; Kawashima, Hideyuki ; Nara, Yugo ; Kataoka, Akihisa ; Shirai, Shinichi ; Tada, Norio ; Araki, Motoharu ; Takagi, Kensuke ; Yamanaka, Futoshi ; Yamamoto, Masanori ; Hayashida, Kentaro. / Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer. In: American Journal of Cardiology. 2016 ; Vol. 118, No. 4. pp. 572-577.
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abstract = "The aim of this study was to evaluate postprocedural and midterm outcomes of transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis and active cancer. From October 2013 to August 2015, a total of 749 patients undergoing TAVI using the Edwards Sapien XT prosthesis (Edwards Lifesciences, Irvine, California) were prospectively included in the OCEAN-TAVI registry from 8 Japanese centers. A total of 47 patients (44.7{\%} men; median age 83 years) had active cancer. The transfemoral approach was implemented in 85.1{\%} of patients in the cancer group and 78.1{\%} in the noncancer group (p = 0.22). The occurrence of major vascular complication (4.3{\%} vs 7.5{\%}, p = 0.24), life-threatening bleeding (2.1{\%} vs 7.1{\%}, p = 0.15), and major bleeding (8.5{\%} vs 13{\%}, p = 0.38) was similar between the cancer and noncancer groups. No significant differences were observed regarding device success (100{\%} vs 96.2{\%}, p = 0.17) or 30-day survival (95.7{\%} vs 97.3{\%}, p = 0.38). No difference in midterm survival was found between the patients with cancer and without cancer (log-rank, p = 0.42), regardless of advanced or limited cancer (log-rank, p = 0.68). In a multivariable Cox proportional hazard regression analysis, cancer metastasis was one of the most significant predictors of late mortality (hazard ratio 4.73, 95{\%} CI 1.12 to 20.0; p = 0.035). In conclusion, patients with cancer with severe aortic stenosis who underwent TAVI had similar acute outcomes and midterm survival rates compared with patients without cancer. Cancer metastasis was associated with increased mortality after TAVI.",
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AU - Nara, Yugo

AU - Kataoka, Akihisa

AU - Shirai, Shinichi

AU - Tada, Norio

AU - Araki, Motoharu

AU - Takagi, Kensuke

AU - Yamanaka, Futoshi

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