Systemic corticosteroid exposure and atrioventricular conductance delays after transcatheter aortic valve implantation.

Bernhard, Benedikt; Okuno, Taishi; Cicovic, Aleksandar; Stortecky, Stefan; Reichlin, Tobias; Lanz, Jonas; Praz, Fabien; Windecker, Stephan; Pilgrim, Thomas (2022). Systemic corticosteroid exposure and atrioventricular conductance delays after transcatheter aortic valve implantation. Cardiovascular revascularization medicine, 37, pp. 1-6. Elsevier 10.1016/j.carrev.2021.06.127

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BACKGROUND

Atrioventricular conduction delays (AVCD) are common after transcatheter aortic valve implantation (TAVI) and frequently require implantation of a permanent pacemaker (PPM). Autopsy studies demonstrated the role of ischemia, inflammation, and oedema in the pathogenesis of AVCD. Corticosteroids (CS) reduce inflammation and oedema and hence might lead to a lower rate of AVCD.

METHODS

Based on a prospective single-center registry, we performed a propensity score (PS) matched analysis of subjects treated with or without systemic CS (>2.5 mg prednisolone-equivalent per day) at the time of TAVI. The primary endpoint was a composite of PPM-implantation and new-onset left bundle branch block (LBBB) within 30 days after TAVI.

RESULTS

Among 2213 consecutive patients undergoing TAVI (51.5% female, mean age 82.1 ± 6.1 years) 89 patients were treated with systemic CS, of which 87 were included in the PS matched analysis. At 30 days, rates of the composite of PPM and LBBB were comparable between patients with versus without CS both in the overall cohort (33.7% versus 33.0%, p = 0.89) and the PS matched cohort (34.5% versus 40.2%, p = 0.443). There were no differences in a composite of major or minor vascular complications and major or life-threatening bleeding events between patients with versus without CS in the overall cohort (34.8% versus 26.6%, p = 0.088) or the PS matched cohort (33.3% versus 33.3%, p ≥ 0.999).

CONCLUSION

In this exploratory study, intake of systemic CS among patients undergoing TAVI was not associated with differences in rates of AVCD, vascular complications, or bleeding events after TAVI.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Bernhard, Benedikt; Okuno, Taishi; Stortecky, Stefan; Reichlin, Tobias Roman; Lanz, Jonas; Praz, Fabien Daniel; Windecker, Stephan and Pilgrim, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1553-8389

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

20 Jan 2022 10:34

Last Modified:

13 Apr 2022 00:12

Publisher DOI:

10.1016/j.carrev.2021.06.127

PubMed ID:

34238680

Uncontrolled Keywords:

Atrioventricular conduction delay Left bundle branch block Permanent pacemaker implantation Systemic corticosteroids Transcatheter aortic valve implantation

BORIS DOI:

10.48350/163195

URI:

https://boris.unibe.ch/id/eprint/163195

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