Cardiovascular Outcomes Among Mitraclip Patients With Atrial Fibrillation vs Those Without

Author Type(s)

Resident/Fellow

Document Type

Abstract

Publication Date

2022

Journal Title

Journal of the American College of Cardiology

Department

Medicine

Abstract

Background: The use of the MitraClip device (Abbott Vascular) for symptomatic mitral regurgitation is increasingly gaining ground in recent years. The outcomes of Mitraclip placement in patients with atrial fibrillation (AF) remain unknown. Methods: The Nationwide Readmissions Database was queried between 2015 and 2018. International Classification of Diseases-10th Revision codes were used to identify patients with the MitraClip. The MitraClip patients were divided into 2 groups: those with AF versus those without. We assessed cardiovascular outcomes and readmission rates at 30, 90, and 180 days. Stata v.17 (StataCorp LLC) was used for statistical analysis. Results: A total of 16,591 patients with the MitraClip were included in our analysis from 2015 to 2108: 10,457 (63%) with AF versus 6,134 (37%) without. The mean age was 79.5 and 75.9 years, respectively, for patients with AF versus those without. Hyperlipidemia (60% vs 60%) and smoking (34% vs 34%) were the most common baseline variables for both groups (P > 0.05) (Figure). AF was associated with higher rates of heart failure (84.7% vs 76.3%; P < 0.001) and acute kidney injury (18.6% vs 15.5%; P < 0.001) in MitraClip patients compared with those without, whereas patients without AF had a higher incidence of myocardial infarction (2.5% vs 1.7%; P < 0.05). Additionally, patients with AF had higher readmissions rates within 30 days (16% vs 12%), 90 days (22% vs 18%), and 180 days (20% vs 16%) and experienced a longer mean hospital length of stay compared with those without AF (P < 0.001 for all). [Formula presented] Conclusion: AF was associated with worse outcomes with a higher rate of heart failure, acute kidney injury, and hospital readmission compared with those without AF among MitraClip recipients. Categories: STRUCTURAL: Valvular Disease: Mitral

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