Background:
Little is known about the outcomes of Trans-catheter aortic valve replacement (TAVR) in patients with rheumatoid arthritis (RA).
Methods:
We queried the National Inpatient Sample database (2011-2014) to identify patients who underwent TAVR. We performed a propensity matching analysis including 23 variables to compare TAVR in patients with RA versus not.
Results:
Our final analysis included 42,189 patients who underwent TAVR, 888 (2.1%) had RA. After matching, TAVR in patients with RA was associated with higher rates of cardiac tamponade (0.6% vs. 0.0%, p=0.031), blood transfusion requirements (25.1% vs. 18.9%, p=0.003), complete heart block (13.4% vs. 7.9%, p<0.001) and pacemaker insertions (9.8% vs. 5.5%, p=0.001) compared with those with no RA. While TAVR in patients with RA was associated with lower rates of acute kidney injury (9.8% vs. 18.9%, p<0.001). No differences were observed between both groups in vascular complications (0.6% vs. 1.2%, p=0.300), acute myocardial infarction (3.1% vs. 1.8%, p=0.113), percutaneous coronary intervention (2.4% vs. 2.4%, p>0.999), hemodialysis (0.0% vs. 0.6%, p=0.062), use of mechanical circulatory support (1.2% vs. 2.4%, p=0.096), major bleeding (35.9% vs. 32.5%, p=0.145), ventricular arrhythmias (2.4% vs. 2.4%, p>0.999), respiratory complications (1.2% vs. 0.6%, p=0.208) and discharges to nursing facilities (29.2% vs. 29.2%, p>0.999).
Conclusions:
Patients with RA undergoing TAVR might be liable to certain procedural related morbidities. Further studies exploring the outcomes of TAVR in RA patients are needed.
