PMID- 37748243 OWN - NLM STAT- MEDLINE DCOM- 20231106 LR - 20231112 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 207 DP - 2023 Nov 15 TI - Chronic Limb-Threatening Ischemia Is Associated With Higher Mortality and Limb Revascularization After Transcatheter Aortic Valve Replacement. PG - 202-205 LID - S0002-9149(23)00887-1 [pii] LID - 10.1016/j.amjcard.2023.08.114 [doi] AB - Peripheral arterial disease (PAD) is common in patients with symptomatic aortic stenosis. PAD exists as a spectrum, and patients with chronic limb-threatening ischemia (CLTI), the most severe form of PAD, are at high risk for limb loss and death. We seek to determine patient characteristics and clinical outcomes among patients who underwent TAVR with or without CLTI. We identified all hospitalizations for TAVR from October 2015 to December 2018 using the National Inpatient Sample database. Patients with any diagnosis of CLTI were identified using the International Classification of Diseases 10th Revision codes. The primary outcome was in-hospital mortality, and secondary outcomes were major complications, open revascularization, and endovascular revascularization after TAVR. During the study period, a total of 31,335 hospitalizations for TAVR procedures were included, including 7,048 (22.5%) in patients with CLTI. CLTI was associated with higher in-hospital mortality (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.13 to 1.74, p = 0.002) and major complications (OR 1.2, 95% CI 1.09 to 1.25, p <0.001). CLTI was also associated with a significantly higher rate of open limb revascularization (OR 5.1, 95% CI 3.94 to 6.48, p <0.001) and endovascular revascularization (OR 4.0, 95% CI 3.54 to 4.59, p <0.001). CLTI among patients who underwent TAVR is associated with higher in-hospital mortality, major complications, and longer lengths of stay compared with patients without CLTI. However, the overall rates of adverse events remain low. Further studies are needed to optimize the multidisciplinary care of these patients before TAVR with a focus on shared decision-making. CI - Published by Elsevier Inc. FAU - Shah, Khanjan B AU - Shah KB AD - Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida. Electronic address: Khanjan.Shah@medicine.ufl.edu. FAU - Elzeneini, Mohammed AU - Elzeneini M AD - Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida. FAU - Neal, Dan AU - Neal D AD - Department of Surgery, University of Florida, Gainesville, Florida. FAU - Kamisetty, Sujay AU - Kamisetty S AD - Department of Internal Medicine, University of Florida, Gainesville, Florida. FAU - Winchester, David AU - Winchester D AD - Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida. FAU - Shah, Samir K AU - Shah SK AD - Division of Vascular Surgery, University of Florida, Gainesville, Florida. LA - eng PT - Journal Article DEP - 20230924 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Transcatheter Aortic Valve Replacement/adverse effects MH - Chronic Limb-Threatening Ischemia MH - Risk Factors MH - Ischemia/epidemiology/etiology/surgery MH - Vascular Surgical Procedures MH - *Peripheral Arterial Disease/complications/epidemiology/surgery MH - Treatment Outcome MH - *Endovascular Procedures/methods MH - Chronic Disease MH - Retrospective Studies OTO - NOTNLM OT - CLTI OT - PAD OT - TAVR COIS- Declaration of Competing Interest The authors have no competing interests to declare. EDAT- 2023/09/26 00:42 MHDA- 2023/11/06 06:42 CRDT- 2023/09/25 18:01 PHST- 2023/06/02 00:00 [received] PHST- 2023/08/14 00:00 [revised] PHST- 2023/08/20 00:00 [accepted] PHST- 2023/11/06 06:42 [medline] PHST- 2023/09/26 00:42 [pubmed] PHST- 2023/09/25 18:01 [entrez] AID - S0002-9149(23)00887-1 [pii] AID - 10.1016/j.amjcard.2023.08.114 [doi] PST - ppublish SO - Am J Cardiol. 2023 Nov 15;207:202-205. doi: 10.1016/j.amjcard.2023.08.114. Epub 2023 Sep 24.