Impact of Atrial Fibrillation on Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI): The K-TAVI Registryopen access
- Authors
- Lee, Sang Yoon; Choi, Ki Hong; Park, Taek Kyu; Kim, Jihoon; Kim, Eun Kyoung; Park, Sung-Ji; Park, Seung Woo; Gwon, Hyeon-Cheol; Chang, Kiyuk; Yu, Cheol Woong; Kim, JuHan; Choi, Young Jin; Chae, In-Ho; Lee, Jae-Hwan; Kim, Jun-Hong; Park, Jong Seon; Kim, Won-Jang; Yoon, Young Won; Ahn, Tae Hoon; Lee, Sang Rok; Choi, Byoung Joo; Yang, Tae-Hyun; Choi, Cheol Ung; Hur, Seung-Ho; Oh, Seong-Jin; Lee, Han Cheol; Park, HunSik; Kim, Hyo-Soo; Choi, Seung-Hyuk
- Issue Date
- Jul-2023
- Publisher
- YONSEI UNIV COLL MEDICINE
- Keywords
- Transcatheter aortic valve implantation; atrial fibrillation; Korean; antithrombotic agent
- Citation
- YONSEI MEDICAL JOURNAL, v.64, no.7, pp.413 - 422
- Journal Title
- YONSEI MEDICAL JOURNAL
- Volume
- 64
- Number
- 7
- Start Page
- 413
- End Page
- 422
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/88885
- DOI
- 10.3349/ymj.2022.0649
- ISSN
- 0513-5796
- Abstract
- Purpose: The incidence and prognostic implications of atrial fibrillation (AF) in patients with severe aortic stenosis (AS) undergo-ing transcatheter aortic valve implantation (TAVI) are controversial, especially for Korean patients. Furthermore, the pattern of an-tithrombotic therapy for these patients is unknown. The present study sought to identify the impact of AF on Korean patients un-dergoing TAVI and demonstrate the status of antithrombotic therapy for these patients.Materials and Methods: A total of 660 patients who underwent TAVI for severe AS were recruited from the nationwide K-TAVI registry in Korea. The enrolled patients were stratified into sinus rhythm (SR) and AF groups. The primary endpoint was all-cause death at 1-year.Results: AF was recorded in 135 patients [pre-existing AF 108 (16.4%) and new-onset AF 27 (4.1%)]. The rate of all-cause death at 1 year was significantly higher in patients with AF than in those with SR [16.2% vs. 6.4%, adjusted hazard ratio (HR): 2.207, 95% con-fidence interval (CI): 1.182-4.120, p=0.013], regardless of the onset timing of AF. The rate of new pacemaker insertion at 1 year was also significantly higher in patients with AF than in those with SR (14.0% vs. 5.5%, adjusted HR: 3.137, 95%CI: 1.621-6.071, p=0.001). Among AF patients, substantial number of patients received the combination of multiple antithrombotic agents (77.8%), and the most common combination was that of aspirin and clopidogrel (38.1%).Conclusion: AF was an independent predictor of 1-year mortality and new pacemaker insertion in Korean patients undergoing TAVI.
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