Abstract 4146071: Post Transcatheter Aortic Valve Replacement outcomes among patients with Cardiac Amyloidosis and Aortic Stenosis.

Background: Aortic stenosis (AS) and cardiac amyloidosis (CA) frequently coexist. There is a paucity of data on whether the presence of CA impacts post-procedural and clinical outcomes after transcatheter aortic valve replacement (TAVR) among AS patients. Objective: In this analysis, we sought to leverage data from the TriNeTX Global Collaborative Network to determine the impact of CA on mortality and cardiovascular/ischemic outcomes at 1-month and 1-year post-TAVR. Methods: The TriNeTX Global Collaborative Network research database was used to identify patients aged ≥18 years from January 2012 to April 2023. Patients with AS were categorized into two groups: one with CA and having TAVR, and a control group with non CA group having TAVR. Patients were followed for 1 month and 1 year respectively. Propensity score-matched analysis (PSM) (1:1) was performed on age, gender, race, hypertension, diabetes mellitus, and chronic kidney disease. Primary outcome was all-cause mortality (ACM), while secondary outcomes were acute myocardial infarction (AMI), ischemic stroke, ventricular arrhythmias, and major adverse cardiovascular event (composite of ACM, ischemic stroke and AMI). Results: After 1:1 PSM, the study cohort comprised of 351 patients in the CA group and 351 patients in the non-CA group. The mean age of patients in CA and non-CA groups was 79.6 and 79.5 years. PSM analysis showed that ACM was comparable between CA and non-CA group after 1-month (RR, 1.00 (95%CI: 0.42-2.39), P =0.98), and after 1-year follow up (RR, 0.92 (95%CI: 0.59-1.44), P =0.736). AMI was also found comparable between the two cohorts, both after 1-month (RR, 1.189 (95%CI: 0.503-2.811), P =0.693), and after 1-year (RR, 1.288 (95%CI: 0.598-2.773), P =0.516). Similar trends were found for ischemic stroke, ventricular arrhythmias and MACE both after 1-month and 1-year follow up. Conclusion: This study shows that TAVR can be safe to be considered among cardiac amyloidosis patients with aortic stenosis