Patients with obstructive sleep apnea (OSA) who receive transcatheter aortic valve replacement (TAVR) have a higher risk for atrial fibrillation (AF), cardiac arrest, stroke, and redo-TAVR or redo-surgical aortic valve replacement (SAVR) compared with those without OSA. These findings were presented at the American College of Cardiology 71st Annual Scientific Session & Expo, from April 2nd through 4th, in Washington, DC.

A retrospective cohort study was conducted with the use of TriNetX, a national federated real-time database that contains 69 million records. Although short-term outcomes among patients receiving TAVR have been studied, data on long-term outcomes are sparse. The researchers sought to evaluate 3-year complications in patients with OSA who receive TAVR. All patient cohorts were identified if they met OSA criteria and had undergone a TAVR procedure up until October 1, 2018, in order to meet the 3-year follow-up.

A 1:1 matched propensity score analysis was carried out, with adjustments made for patient comorbidities and demographics, in order to calculate adjusted risk ratios (aRRs) with 95% CIs for any complications of interest. Kaplan-Meier analysis was performed to compute survival probability in 3 years among the 2 cohorts.


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A total of 2182 participants were enrolled in each study arm. The study arms were patients with OSA and patients without OSA (control arm) who received TAVR. Individuals with OSA had a significantly greater risk for AF (aRR, 1.339; 95% CI, 1.251-1.433), cardiac arrest (aRR, 1.554; 95% CI, 1.144-2.110), stroke (aRR, 1.403; 95% CI, 1.155-1.704), and redo-TAVR or SAVR (aRR, 1.430; 95% CI, 1.134-1.803) compared with those without OSA.

No statistically significant differences were reported between the 2 cohorts in other long-term complications that were evaluated, which included mortality (aRR, 1.045; 95% CI, 0.931-1.172) and pacemaker placement (aRR, 1.170; 95% CI, 0.973 -1.406).

Further, Kaplan-Meier analysis for mortality did not achieve a statistically significant difference in 3-year survival probability in the OSA group vs the control group (hazard ratio, 0.957; 95% CI, 0.841-1.089; P =.5025).

“Additional research is needed to visit further longer-term impacts in patients with [OSA],” the researchers wrote.

Disclosure: None of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies.  

Reference

Raiker R. Examining 3-year outcomes in patients with obstructive sleep apnea who underwent transcatheter aortic valve replacement. Presented at: American College of Cardiology 71st Annual Scientific Session & Expo; April 2-4, 2022; Washington, DC.

HealthDay News — Pfizer Inc. announced Tuesday that it has launched a trial that will compare its existing COVID-19 vaccine against a new version tailored to beat back the highly contagious omicron variant.

“While current research and real-world data show that boosters continue to provide a high level of protection against severe disease and hospitalization with omicron, we recognize the need to be prepared in the event this protection wanes over time and to potentially help address omicron and new variants in the future,” Kathrin Jansen, senior vice president and head of vaccine research & development at Pfizer, said in a company statement. “Staying vigilant against the virus requires us to identify new approaches for people to maintain a high level of protection, and we believe developing and investigating variant-based vaccines, like this one, are essential in our efforts towards this goal.”

The new U.S. study will include up to 1,420 healthy adults, aged 18 to 55 years, and will assess the updated, omicron-targeted vaccine for use as a booster or for primary vaccinations. The modified vaccine’s safety and how it bolsters the immune system in comparison to the original vaccine will be examined by the researchers. Volunteers will receive varying vaccine doses and will be monitored for how long virus-fighting antibodies remain at high levels after vaccination, so it could take months for the full study results to be available.

One group of roughly 600 volunteers who received two doses of the original Pfizer vaccine three to six months ago will receive either one or two omicron-based shots as boosters. Another 600 who have already received three doses of the original Pfizer vaccine will be given a fourth dose of either the regular vaccine or the omicron-matched version. The study also will enroll some unvaccinated volunteers who will receive three doses of the omicron-based vaccine.


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This article originally appeared on The Cardiology Advisor