Transcatheter Aortic Valve Replacement Outcomes in End-Stage Renal Disease Patients on Hemodialysis Requiring Midodrine.
washington; oregon; montana; california; swedish; pshmc; cards; cards publication; missoula; orange; everett; prmc; End stage renal disease; Midodrine; Survival; Transcatheter aortic valve replacement
BACKGROUND: Patients with dialysis-dependent end-stage renal disease (ESRD) taking midodrine may be at high risk for poor outcomes following transcatheter aortic valve replacement (TAVR). We evaluated dialysis-dependent ESRD patients taking midodrine.
METHODS: We conducted a retrospective analysis of non-clinical trial TAVR patients from February 2012 to December 2020 from 11 facilities in a Western US health system. Patient groups included ESRD patients on midodrine before TAVR (ESRD [+M]), ESRD patients without midodrine (ESRD [-M]), and non-ESRD patients. The endpoints of 30-day and 1-year mortality were represented by Kaplan-Meier survival estimator and compared by log-rank test.
RESULTS: Forty-five ESRD (+M), 216 ESRD (-M), and 6898 non-ESRD patients were included. ESRD patients had more comorbid conditions, despite no significant difference in predicted Society of Thoracic Surgeons mortality risk between ESRD (+M) and ESRD (-M) (8.7% vs. 9.2%,
CONCLUSIONS: Our experience suggests ESRD patients on midodrine are a higher acuity population with worse survival after TAVR, compared to ESRD patients not on midodrine. These findings may help with risk stratification for ESRD patients undergoing TAVR.
Kidney & Diabetes
Center for Cardiovascular Analytics, Research + Data Science (CARDS)
Korngold, Ethan C; Jin, Ruyun; Spinelli, Kateri; Kumar, V; Curtis, Brydan; Gafoor, Sameer; Phan, Derek; Spoon, Daniel; Raney, Aidan; McCabe, Lisa; and Jones, Brandon, "Transcatheter Aortic Valve Replacement Outcomes in End-Stage Renal Disease Patients on Hemodialysis Requiring Midodrine." (2023). Articles, Abstracts, and Reports. 7516.