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

Preview

Text Systemic_corticosterid.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (998kB) | Preview

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.

Interest & Impact

Downloads

44 since deposited on 20 Jan 2022
37 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item