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Impact of Atrial Fibrillation on Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI): The K-TAVI Registry

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Author(s)
Sang Yoon LeeKi Hong ChoiTaek Kyu ParkJihoon KimEun Kyoung KimSung-Ji ParkSeung Woo ParkHyeon-Cheol GwonKiyuk ChangCheol Woong YuJuHan KimYoung Jin ChoiIn-Ho ChaeJae-Hwan LeeJun-Hong KimJong Seon ParkWon-Jang KimYoung Won YoonTae Hoon AhnSang Rok LeeByoung Joo ChoiTae-Hyun YangCheol Ung ChoiSeung-Ho HurSeong-Jin OhHan Cheol LeeHunSik ParkHyo-Soo KimSeung-Hyuk Choi
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Yonsei Med J
Issued Date
2023
Volume
64
Issue
7
Keyword
KoreanTranscatheter aortic valve implantationantithrombotic agentatrial fibrillation
Abstract
Purpose:
The incidence and prognostic implications of atrial fibrillation (AF) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) are controversial, especially for Korean patients. Furthermore, the pattern of antithrombotic therapy for these patients is unknown. The present study sought to identify the impact of AF on Korean patients undergoing TAVI and demonstrate the status of antithrombotic therapy for these patients.

Materials and methods:
A total of 660 patients who underwent TAVI for severe AS were recruited from the nationwide K-TAVI registry in Korea. The enrolled patients were stratified into sinus rhythm (SR) and AF groups. The primary endpoint was all-cause death at 1-year.

Results:
AF was recorded in 135 patients [pre-existing AF 108 (16.4%) and new-onset AF 27 (4.1%)]. The rate of all-cause death at 1 year was significantly higher in patients with AF than in those with SR [16.2% vs. 6.4%, adjusted hazard ratio (HR): 2.207, 95% confidence interval (CI): 1.182-4.120, p=0.013], regardless of the onset timing of AF. The rate of new pacemaker insertion at 1 year was also significantly higher in patients with AF than in those with SR (14.0% vs. 5.5%, adjusted HR: 3.137, 95%CI: 1.621-6.071, p=0.001). Among AF patients, substantial number of patients received the combination of multiple antithrombotic agents (77.8%), and the most common combination was that of aspirin and clopidogrel (38.1%).

Conclusion:
AF was an independent predictor of 1-year mortality and new pacemaker insertion in Korean patients undergoing TAVI.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1976-2437
Source
https://eymj.org/DOIx.php?id=10.3349/ymj.2022.0649
DOI
10.3349/ymj.2022.0649
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45308
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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