PMID- 34340914 OWN - NLM STAT- MEDLINE DCOM- 20220511 LR - 20220514 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 38 DP - 2022 May TI - Impact of New York Heart Association Functional Class on Outcomes After Transcatheter Aortic Valve Implantation. PG - 19-26 LID - S1553-8389(21)00550-9 [pii] LID - 10.1016/j.carrev.2021.07.022 [doi] AB - BACKGROUND: In the current guidelines, indications for transcatheter aortic valve implantation (TAVI) are expanded to include several subgroups of asymptomatic patients with severe aortic stenosis (AS), and there is a paucity of data on the prognostic impact of New York Heart Association (NYHA) functional class in patients with severe AS undergoing TAVI. METHODS: Among 2588 patients enrolled in the OCEAN-TAVI registry, patients were divided into 4 groups according to baseline NYHA class (class I in 95 patients, class II in 1172 patients, class III in 1126 patients, and class IV in 195 patients). RESULTS: Median follow-up was 729 days. The cumulative 2-year incidence of all-cause death was significantly higher in patients with NYHA class IV and III than in those with NYHA class II and I. (30.0%, 21.3%, 13.4%, and 11.2%, respectively, P < 0.001). After adjusting confounders, NYHA class IV and III, but not NYHA class II were independently associated with higher mortality compared with NYHA class I (reference) (adjusted HR: 3.43, 95%CI: 1.83-7.15, P < 0.001; adjusted HR: 2.07, 95%CI: 1.15-4.19, P = 0.013; and adjusted HR: 1.50, 95%CI: 0.83-3.04, P = 0.19, respectively). With increasing NYHA class, there was an incremental increase of heart failure hospitalization in the effect size relative to the reference (NYHA class I). CONCLUSIONS: The long-term outcomes of patients with NYHA class I were better than those with NYHA class IV or III in some selected patients undergoing TAVI. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Taniguchi, Tomohiko AU - Taniguchi T AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. Electronic address: ta2guchi@kuhp.kyoto-u.ac.jp. FAU - Shirai, Shinichi AU - Shirai S AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ando, Kenji AU - Ando K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Arai, Yoshio AU - Arai Y AD - Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Soga, Yoshiharu AU - Soga Y AD - Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Hayashi, Masaomi AU - Hayashi M AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Isotani, Akihiro AU - Isotani A AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Tada, Norio AU - Tada N AD - Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan. FAU - Watanabe, Yusuke AU - Watanabe Y AD - Division of Cardiology, Department of Internal Medicine, Teikyo University Hospital, Tokyo, Japan. FAU - Naganuma, Toru AU - Naganuma T AD - Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan. FAU - Yamanaka, Futoshi AU - Yamanaka F AD - Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan. FAU - Yamawaki, Masahiro AU - Yamawaki M AD - Department of Cardiovascular Medicine, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan. FAU - Mizutani, Kazuki AU - Mizutani K AD - Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. FAU - Tabata, Minoru AU - Tabata M AD - Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan. FAU - Ueno, Hiroshi AU - Ueno H AD - Department of Cardiovascular Medicine, Toyama University School of Medicine, Toyama, Japan. FAU - Kuwabara, Kensuke AU - Kuwabara K AD - Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan. FAU - Takagi, Kensuke AU - Takagi K AD - Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan. FAU - Yashima, Fumiaki AU - Yashima F AD - Department of Cardiology, Saiseikai Utsunomiya Hospital, Japan; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Yamamoto, Masanori AU - Yamamoto M AD - Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan. FAU - Hayashida, Kentaro AU - Hayashida K AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. CN - OCEAN-TAVI Investigators LA - eng PT - Journal Article DEP - 20210724 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM CIN - Cardiovasc Revasc Med. 2022 May;38:27-28. PMID: 35181264 MH - Aortic Valve/diagnostic imaging/surgery MH - *Aortic Valve Stenosis/diagnostic imaging/etiology/surgery MH - Humans MH - New York MH - Registries MH - Risk Factors MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - Aortic stenosis OT - New York Heart Association functional class OT - Transcatheter aortic valve implantation COIS- Declaration of competing interest Dr. Yamamoto, Dr. Tada, Dr. Naganuma, Dr. Shirai, Dr. Mizutani, Dr. Watanabe, Dr. Tabata and Dr. Ueno are clinical proctors for Edwards Lifesciences and Medtronic. Dr. Arai, Dr. Takagi, and Dr. Hayashida are clinical proctors of Edwards Lifesciences. The remaining authors have nothing to disclose. EDAT- 2021/08/04 06:00 MHDA- 2022/05/12 06:00 CRDT- 2021/08/03 05:45 PHST- 2021/06/21 00:00 [received] PHST- 2021/07/16 00:00 [revised] PHST- 2021/07/21 00:00 [accepted] PHST- 2021/08/04 06:00 [pubmed] PHST- 2022/05/12 06:00 [medline] PHST- 2021/08/03 05:45 [entrez] AID - S1553-8389(21)00550-9 [pii] AID - 10.1016/j.carrev.2021.07.022 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2022 May;38:19-26. doi: 10.1016/j.carrev.2021.07.022. Epub 2021 Jul 24.