Effect of Stroke on Readmissions and Cardiovascular Outcomes in Patients With Mitraclip

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 transcatheter edge-to-edge repair for significant symptomatic mitral regurgitation is becoming increasingly popular in recent years. However, the association of stroke on outcomes of MitraClip placement in patients has not been adequately reported in the literature. Methods: We queried the National Readmission Database from 2015 to 2018 using International Classification of Diseases-10th Revision codes to identify patients who underwent MitraClip with and without stroke. We studied the impact of stroke on readmissions in 30 days, 90 days, and 180 days. Results: A total of 16,591 patients were analyzed from 2015 to 2018. There were 151.1 (0.9%) patients with stroke and 16,441 (99.1%) without. The stroke subgroup had a significantly higher prevalence of hypertension (43% vs 32%), deficiency anemia (48% vs 21%), plasma and electrolytes disorders (51% vs 17%), congestive heart failure (27% vs 3.9%), and vascular diseases (26% vs 4.6%) compared with patients without stroke. Stroke was associated with higher readmission rates at 30 days (83% vs 22%), 90 days (67% vs 20%), and 180 days (76% vs 19%) with a longer mean length of hospital stay compared with those without stroke. Also, patients with stroke had a statistically significant higher rate of AKI (100% vs 17%), heart failure (89.3% vs 81.6%), inpatient mortality (23.3% vs 2.2%), nonhome discharge (36.1% vs 10.1%), myocardial infarction (16% vs 1.9%), and mechanical circulatory support (9.2% vs 2.1%; with all P < 0.05) (Figure). [Formula presented] Conclusion: The presence of stroke is associated with worse cardiovascular outcomes, a longer mean hospital length of stay, and higher readmission rates in patients with MitraClip compared with those without stroke. Categories: ENDOVASCULAR: Stroke, Stroke Prevention, Carotid Intervention

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