Impact of pre-procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement: A propensity-matched analysis

Ai Kagase, Masanori Yamamoto, Tetsuro Shimura, Atsuko Kodama, Seiji Kano, Yutaka Koyama, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida

Research output: Contribution to journalArticle

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Abstract

Background: Hyponatremia is associated with the increased risk of early and late mortality in patients with cardiac disease. This study aimed to assess the prognostic value of hyponatremia in patients who had undergone transcatheter aortic valve replacement (TAVR). Methods: We investigated 1,215 consecutive patients (mean age: 84.4±5.0 years) who underwent TAVR using data from the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVR Japanese multicenter registry. Hyponatremia was defined as a serum sodium value less than 135 mEq/L. The baseline characteristics, procedural outcomes, all-cause, cardiovascular, and non-cardiovascular mortality were compared between patients with hyponatremia (n=106, 8.7%) and without hyponatremia (n=1,109, 91.3%). A propensity-matching analysis was used to adjust for the non-uniform patient characteristics. Results: Differences in the baseline characteristics were observed between the two groups regarding the prevalence of pulmonary disease (37.7% vs. 28.9%, P=0.04) and the performance of non-elective TAVR (10.4% vs. 4.2%, P=0.01), although these were minimized in the matched model. The 30-day mortality rates differed between the two groups (7.6% vs. 1.4%, P<0.001). During a mean follow-up of 330 days, the all-cause and cardiovascular mid-term mortality were higher in the hyponatremia group than in the non-hyponatremia group (log-rank test: P=0.0047, and P<0.001, respectively). The three findings above were not attenuated in the propensity-matched model (P<0.001, P=0.0044, and P=0.014, respectively). In contrast, there was no difference in non-cardiovascular mortality between the two groups in both the overall and matched model (P=0.40 and P=0.13, respectively). Conclusions: Pre-procedural hyponatremia may be a useful marker for predicting early and mid-term clinical outcomes after TAVR.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusAccepted/In press - 2018 Jan 1

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Hyponatremia
Mortality
Transcatheter Aortic Valve Replacement
Lung Diseases
Registries
Heart Diseases
Catheters
Sodium
Serum

Keywords

  • Clinical outcomes
  • Hyponatremia
  • Transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Impact of pre-procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement : A propensity-matched analysis. / Kagase, Ai; Yamamoto, Masanori; Shimura, Tetsuro; Kodama, Atsuko; Kano, Seiji; Koyama, Yutaka; Tada, Norio; Naganuma, Toru; Araki, Motoharu; Yamanaka, Futoshi; Shirai, Shinichi; Watanabe, Yusuke; Hayashida, Kentaro.

In: Catheterization and Cardiovascular Interventions, 01.01.2018.

Research output: Contribution to journalArticle

Kagase, A, Yamamoto, M, Shimura, T, Kodama, A, Kano, S, Koyama, Y, Tada, N, Naganuma, T, Araki, M, Yamanaka, F, Shirai, S, Watanabe, Y & Hayashida, K 2018, 'Impact of pre-procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement: A propensity-matched analysis', Catheterization and Cardiovascular Interventions. https://doi.org/10.1002/ccd.27483
Kagase, Ai ; Yamamoto, Masanori ; Shimura, Tetsuro ; Kodama, Atsuko ; Kano, Seiji ; Koyama, Yutaka ; Tada, Norio ; Naganuma, Toru ; Araki, Motoharu ; Yamanaka, Futoshi ; Shirai, Shinichi ; Watanabe, Yusuke ; Hayashida, Kentaro. / Impact of pre-procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement : A propensity-matched analysis. In: Catheterization and Cardiovascular Interventions. 2018.
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abstract = "Background: Hyponatremia is associated with the increased risk of early and late mortality in patients with cardiac disease. This study aimed to assess the prognostic value of hyponatremia in patients who had undergone transcatheter aortic valve replacement (TAVR). Methods: We investigated 1,215 consecutive patients (mean age: 84.4±5.0 years) who underwent TAVR using data from the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVR Japanese multicenter registry. Hyponatremia was defined as a serum sodium value less than 135 mEq/L. The baseline characteristics, procedural outcomes, all-cause, cardiovascular, and non-cardiovascular mortality were compared between patients with hyponatremia (n=106, 8.7{\%}) and without hyponatremia (n=1,109, 91.3{\%}). A propensity-matching analysis was used to adjust for the non-uniform patient characteristics. Results: Differences in the baseline characteristics were observed between the two groups regarding the prevalence of pulmonary disease (37.7{\%} vs. 28.9{\%}, P=0.04) and the performance of non-elective TAVR (10.4{\%} vs. 4.2{\%}, P=0.01), although these were minimized in the matched model. The 30-day mortality rates differed between the two groups (7.6{\%} vs. 1.4{\%}, P<0.001). During a mean follow-up of 330 days, the all-cause and cardiovascular mid-term mortality were higher in the hyponatremia group than in the non-hyponatremia group (log-rank test: P=0.0047, and P<0.001, respectively). The three findings above were not attenuated in the propensity-matched model (P<0.001, P=0.0044, and P=0.014, respectively). In contrast, there was no difference in non-cardiovascular mortality between the two groups in both the overall and matched model (P=0.40 and P=0.13, respectively). Conclusions: Pre-procedural hyponatremia may be a useful marker for predicting early and mid-term clinical outcomes after TAVR.",
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T1 - Impact of pre-procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement

T2 - A propensity-matched analysis

AU - Kagase, Ai

AU - Yamamoto, Masanori

AU - Shimura, Tetsuro

AU - Kodama, Atsuko

AU - Kano, Seiji

AU - Koyama, Yutaka

AU - Tada, Norio

AU - Naganuma, Toru

AU - Araki, Motoharu

AU - Yamanaka, Futoshi

AU - Shirai, Shinichi

AU - Watanabe, Yusuke

AU - Hayashida, Kentaro

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Hyponatremia is associated with the increased risk of early and late mortality in patients with cardiac disease. This study aimed to assess the prognostic value of hyponatremia in patients who had undergone transcatheter aortic valve replacement (TAVR). Methods: We investigated 1,215 consecutive patients (mean age: 84.4±5.0 years) who underwent TAVR using data from the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVR Japanese multicenter registry. Hyponatremia was defined as a serum sodium value less than 135 mEq/L. The baseline characteristics, procedural outcomes, all-cause, cardiovascular, and non-cardiovascular mortality were compared between patients with hyponatremia (n=106, 8.7%) and without hyponatremia (n=1,109, 91.3%). A propensity-matching analysis was used to adjust for the non-uniform patient characteristics. Results: Differences in the baseline characteristics were observed between the two groups regarding the prevalence of pulmonary disease (37.7% vs. 28.9%, P=0.04) and the performance of non-elective TAVR (10.4% vs. 4.2%, P=0.01), although these were minimized in the matched model. The 30-day mortality rates differed between the two groups (7.6% vs. 1.4%, P<0.001). During a mean follow-up of 330 days, the all-cause and cardiovascular mid-term mortality were higher in the hyponatremia group than in the non-hyponatremia group (log-rank test: P=0.0047, and P<0.001, respectively). The three findings above were not attenuated in the propensity-matched model (P<0.001, P=0.0044, and P=0.014, respectively). In contrast, there was no difference in non-cardiovascular mortality between the two groups in both the overall and matched model (P=0.40 and P=0.13, respectively). Conclusions: Pre-procedural hyponatremia may be a useful marker for predicting early and mid-term clinical outcomes after TAVR.

AB - Background: Hyponatremia is associated with the increased risk of early and late mortality in patients with cardiac disease. This study aimed to assess the prognostic value of hyponatremia in patients who had undergone transcatheter aortic valve replacement (TAVR). Methods: We investigated 1,215 consecutive patients (mean age: 84.4±5.0 years) who underwent TAVR using data from the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVR Japanese multicenter registry. Hyponatremia was defined as a serum sodium value less than 135 mEq/L. The baseline characteristics, procedural outcomes, all-cause, cardiovascular, and non-cardiovascular mortality were compared between patients with hyponatremia (n=106, 8.7%) and without hyponatremia (n=1,109, 91.3%). A propensity-matching analysis was used to adjust for the non-uniform patient characteristics. Results: Differences in the baseline characteristics were observed between the two groups regarding the prevalence of pulmonary disease (37.7% vs. 28.9%, P=0.04) and the performance of non-elective TAVR (10.4% vs. 4.2%, P=0.01), although these were minimized in the matched model. The 30-day mortality rates differed between the two groups (7.6% vs. 1.4%, P<0.001). During a mean follow-up of 330 days, the all-cause and cardiovascular mid-term mortality were higher in the hyponatremia group than in the non-hyponatremia group (log-rank test: P=0.0047, and P<0.001, respectively). The three findings above were not attenuated in the propensity-matched model (P<0.001, P=0.0044, and P=0.014, respectively). In contrast, there was no difference in non-cardiovascular mortality between the two groups in both the overall and matched model (P=0.40 and P=0.13, respectively). Conclusions: Pre-procedural hyponatremia may be a useful marker for predicting early and mid-term clinical outcomes after TAVR.

KW - Clinical outcomes

KW - Hyponatremia

KW - Transcatheter aortic valve replacement

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