Kyle Buchanan

CRT-700.13 Increased Mortality in Patients with Low Gradient and Normal Ejection Fraction Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement

There is an increased awareness of the existence of patients with severe aortic stenosis (AS) (aortic valve area 50%). In a study performed in a surgical population s/p aortic valve replacement

CRT-100.08 Coronary Perfusion Pressure and Left Ventricular Hemodynamics as Predictors of Cardiovascular Collapse following Percutaneous Coronary Intervention

Percutaneous mechanical circulatory support (MCS) continues to evolve. Appropriate patient selection for MCS following percutaneous coronary intervention (PCI) remains a challenge. There may be a role for MCS prior to the development of shock to help unload the ischemic ventricle. The aim of this

CRT-100.73 Sex and Racial Disparities in Outcomes in Patients Undergoing Percutaneous Intervention: Data from a Large Tertiary Center

Cardiovascular disease is the leading cause of death in men and women. However, there exist limited outcomes data for women and blacks after percutaneous coronary intervention (PCI). The aim of this retrospective analysis was to evaluate the 1-year major cardiovascular events (MACE) in patients

Role of contractile reserve as a predictor of mortality in low-flow, low-gradient severe aortic stenosis following transcatheter aortic valve replacement

The aim of this study was to determine the prognostic value of contractile reserve (CR) at baseline in patients with low‐flow, low‐gradient severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).

Clinical Characteristics, Procedural Factors, and Outcomes of Percutaneous Coronary Intervention in Patients With Mechanical and Bioprosthetic Heart Valves

There is scarcity of evidence regarding antiplatelet and anticoagulant therapy in patients with prosthetic valves undergoing percutaneous coronary intervention (PCI). Our goal was to compare clinical outcomes between patients with mechanical or bioprosthetic valves undergoing PCI. The study population comprised patients with either a bioprosthetic or mechanical heart valve in the aortic and/or mitral position undergoing PCI between January 2003 and July 2017. Demographics, admission, and discharge medications as well as procedural details were documented. Outcomes were postprocedural bleeding, length of stay, and in-hospital deaths. Of 211 patients, we identified 119 and 92 patients with a bioprosthetic or mechanical valve, respectively. Mean age was 75 ± 9 years and 66 ± 12 years in bioprosthetic and mechanical valve patients, respectively. Bare-metal stents were used in 18.2% and 30.1% of bioprosthetic and mechanical valve patients, respectively. Major bleeding was documented in 0.8% and 6.5% of bioprosthetic and mechanical valve patients, respectively (p = 0.04). Use of triple therapy (aspirin AND clopidogrel AND oral vitamin K antagonist) was significantly lower in bioprosthetic valve patients compared with mechanical valve patients (12% vs 68%, p <0.001). Our study shows variation in periprocedural anticoagulation and/or antiplatelet choice exists in this population. Patients with mechanical valves experienced higher rates of major bleeding compared with patients with bioprosthetic valves, which could be due to concomitant anticoagulation and dual antiplatelet therapy.

CRT-800.06 Temporal Trends in Screening and Reasons for Deferring Patients from Transcatheter Aortic Valve Replacement

The development of new percutaneous valves, increasing vascular access techniques, and broadening indications for percutaneous aortic valve replacement (TAVR) has increased the treatment options for patients with severe aortic stenosis (AS). The trends in referral patterns and reasons for exclusion

CRT-100.46 Outpatient Trends in Dual Antiplatelet Therapy Following Acute Coronary Syndrome and Primary Percutaneous Coronary Intervention

Dual antiplatelet therapy (DAPT) for 12 months is recommended for patients with acute coronary syndrome (ACS) who undergo percutaneous coronary intervention (PCI). The newer antiplatelet agents prasugrel and ticagrelor reduce cardiovascular events more than clopidogrel in those patients. However,

DOES OBESITY AFFECT BRAIN NATRIURETIC PEPTIDE LEVELS IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION

Results: Median survival was 2.7 ± 2.4 yrs. There were 45 deaths and 4 lung transplants. Obese patients had lower median BNP (interquartile range): 182 (64, 459) vs 373 (89,810) pg/ml, p=0.015. Diabetes mellitus was more frequent in obese patients (p = 0.01) but other comorbidities were not. Age, sex, % idiopathic PAH, PAH medications, WHO functional class (WHO FC), hemodynamics, TTE parameters, and creatinine were similar. Multivariable regression analysis showed significant association of BNP and BMI independent of age, hypertension, diabetes, WHO FC, hemodynamics, or creatinine (p=0.016). BNP was associated with death/transplant and was predictive of 2-year outcomes only in non-obese patients (p=0.001, figure).