Authors: | Khan, S.; Dani, S. S.; Hermann, J.; Neilan, T. G.; Lenihan, D. J.; Fradley, M.; Parikh, R.; Khan, S.; Deswal, A.; Liu, J.; Barac, A.; Labib, S.; Majithia, A.; Nohria, A.; Baron, S. J.; Ganatra, S. |
Article Title: | Safety and efficacy of transcatheter edge-to-edge repair (TEER) in patients with history of cancer |
Abstract: | Background: Surgical therapy has been a long-standing option for valvular heart disease, in patients with history of cancer, it carries an increased risk of complications. Objectives: Transcatheter edge-to-edge repair (TEER) for mitral regurgitation, represents a less invasive option. However, patients with history of cancer have generally been excluded from trials. Methods: A retrospective cohort analysis was performed on de-identified, aggregate patient data from the TriNetX research network. Patients 18 ≥ years of age, who had undergone TEER between January 1, 2013 and May 19, 2021, were identified using the CPT codes and divided into two cohorts based on a history of cancer. Subgroup analysis was performed based on history of systemic antineoplastic therapy. Odds ratio and log-rank test were used to compare the outcomes over 1 and 12-months. Results: In matched cohorts (503 patients in each, mean age 77.7 years, men 55 vs 58 %, white 84 vs 87 % in non-cancer and cancer cohorts respectively), the risk of heart failure exacerbation, all-cause mortality and all-cause hospitalizations were similar at 1 and 12 months among patients undergoing TEER. Risk of major complications (ischemic stroke, blood product transfusion and cardiac tamponade) were also similar. In the cancer cohort, hematologic/lymphoid malignancies were the most common (28.0 %) and 12.5 % patients had a history of metastatic cancer. There was no significant difference in heart failure exacerbation or all-cause mortality based on history of systemic antineoplastic therapy. Conclusions: Overall outcomes following TEER are similar in patients with a history of cancer and should be considered in selected patients in this population. © 2022 The Author(s) |
Keywords: | cancer chemotherapy; aged; survival analysis; major clinical study; drug safety; hypertension; cancer radiotherapy; outcome assessment; follow up; antineoplastic agent; cancer immunotherapy; metastasis; thrombocyte; cohort analysis; creatinine; hemoglobin; practice guideline; retrospective study; hospitalization; body mass; hematologic malignancy; acetylsalicylic acid; heart failure; diabetes mellitus; lymphoma; comorbidity; data analysis; clopidogrel; blood transfusion; antilipemic agent; cholesterol; blood pressure; kaplan meier method; heart left ventricle ejection fraction; health care organization; sodium; atrial fibrillation; beta adrenergic receptor blocking agent; dipeptidyl carboxypeptidase inhibitor; coronary artery disease; disease exacerbation; hyperlipidemia; diuretic agent; ischemic heart disease; caucasian; antithrombocytic agent; cardiomyopathy; angiotensin receptor antagonist; heart tamponade; hispanic; anticoagulant agent; log rank test; valvular heart disease; hemoglobin a1c; propensity score; antineoplastic therapy; ischemic stroke; mitral regurgitation; mitral valve regurgitation; cancer; human; male; article; black person; new york heart association class; electronic health record; sacubitril; malignant neoplasm; all cause mortality; icd-10; ticagrelor; teer; trans catheter edge-to-edge repair; prasugrel; transcatheter edge to edge mitral valve repair; valve-in-valve transcatheter aortic valve implantation |
Journal Title: | International Journal of Cardiology Heart & Vasculature |
Volume: | 44 |
ISSN: | 2352-9067 |
Publisher: | Elsevier BV |
Date Published: | 2023-02-01 |
Start Page: | 101165 |
Language: | English |
DOI: | 10.1016/j.ijcha.2022.101165 |
PROVIDER: | scopus |
PMCID: | PMC9938448 |
PUBMED: | 36820391 |
DOI/URL: | |
Notes: | Article -- Export Date: 1 March 2023 -- Source: Scopus |