Table I.
Baseline characteristics of obese patients in pre- and post-matched treatment cohorts
| Clinical and operative variables | Overall series | Propensity score matched pairs | ||||||
|---|---|---|---|---|---|---|---|---|
| SAVR (N = 1213) n (%) |
TAVI (N = 250) n (%) |
P-value | SAVR (N = 142) n (%) |
TAVI (N = 142) n (%) |
P-value | |||
| Demographic: | ||||||||
| Age [years] | 72.2 ±8.8 | 80.6 ±5.4 | < 0.0001 | 79.7 ±5.2 | 79.5 ±5.7 | 0.78 | ||
| Female | 589 (48.6) | 172 (68.8) | < 0.0001 | 92 (64.8) | 94 (66.2) | 0.81 | ||
| BMI [kg/m2] | 33.2 ±3.3 | 33.9 ±4.2 | 0.02 | 33.3 ±3.2 | 33.7 ±3.7 | 0.30 | ||
| BMI classes [kg/m2]: | 0.03 | 0.56 | ||||||
| 30–35 | 957 (78.9) | 179 (71.6) | 110 (77.5) | 107 (75.4) | ||||
| 35–40 | 205 (16.9) | 54 (21.6) | 27 (19.0) | 25 (17.6) | ||||
| > 40 | 51 (4.2) | 17 (6.8) | 5 (3.5) | 10 (7.0) | ||||
| Haemoglobin [mg/dl] | 12.6 ±1.8 | 11.7 ±1.6 | < 0.0001 | 12.1 ±1.7 | 11.9 ±1.6 | 0.26 | ||
| Albumin [mg/dl] | 3.7 ±0.9 | 3.7 ±0.7 | 0.40 | 3.6 ±1.3 | 3.7 ±0.6 | 0.24 | ||
| eGFR [mg/min/1.73 m2] | 68.5 ±22.0 | 55.5 ±21.6 | < 0.0001 | 56.9 ±18.8 | 58.0 ±21.3 | 0.65 | ||
| Cardiac status: | ||||||||
| LVEF < 50% | 176 (15.7) | 58 (23.4) | 0.00 | 30 (21.1) | 25 (17.6) | 0.42 | ||
| NYHA class III–IV | 497 (41.2) | 166 (67.5) | < 0.0001 | 84 (59.2) | 88 (62.0) | 0.61 | ||
| Unstable angina | 45 (3.8) | 10 (4.1) | 0.82 | 5 (3.5) | 3 (2.1) | 0.41 | ||
| Urgent status | 43 (3.5) | 6 (2.4) | 0.36 | 4 (2.8) | 6 (4.2) | 0.41 | ||
| Concomitant CAD | 385 (31.7) | 56 (22.4) | 0.00 | 29 (20.4) | 31 (21.8) | 0.77 | ||
| Prior AMI | 119 (10.0) | 25 (10.1) | 0.95 | 8 (5.6) | 10 (7.0) | 0.62 | ||
| Pulmonary hypertension | 52 (4.6) | 36 (14.8) | < 0.0001 | 16 (11.3) | 12 (8.5) | 0.45 | ||
| Prior PCI | 152 (12.5) | 68 (27.2) | < 0.0001 | 25 (17.6) | 26 (18.3) | 0.87 | ||
| Prior BAV | 14 (1.2) | 38 (15.2) | < 0.0001 | 1 (0.7) | 19 (13.4) | < 0.0001 | ||
| Peak aortic gradient [mm Hg] | 79.9 ±21.3 | 82.0 ±22.3 | 0.19 | 80.9 ±24.3 | 83.0 ±21.6 | 0.47 | ||
| Mean aortic gradient [mm Hg] | 50.0 ±14.5 | 50.4 ±15.4 | 0.73 | 50.8 ±16.9 | 50.7 ±14.1 | 0.94 | ||
| Comorbidities: | ||||||||
| COPD | 136 (11.2) | 92 (37.1) | < 0.0001 | 37 (26.1) | 36 (25.4) | 0.89 | ||
| Diabetes mellitus | 396 (32.6) | 102 (40.8) | 0.01 | 57 (40.1) | 57 (40.1) | 1.00 | ||
| Long-term dialysis | 9 (0.7) | 2 (0.8) | 0.92 | 1 (0.7) | 1 (0.7) | 1.00 | ||
| Neurological dysfunction | 22 (1.8) | 18 (7.2) | < 0.0001 | 8 (5.6) | 10 (7.0) | 0.62 | ||
| Peripheral arteriopathy | 172 (14.4) | 48 (19.7) | 0.04 | 26 (18.3) | 26 (18.3) | 1.00 | ||
| Chronic liver disease† | 17 (1.5) | 5 (2.0) | 0.52 | 4 (2.3) | 3 (2.1) | 0.71 | ||
| Smoking history | 218 (18.7) | 23 (9.8) | 0.00 | 18 (14.0) | 14 (10.9) | 0.47 | ||
| Frailty score, moderate-severe | 65 (5.4) | 70 (28.0) | < 0.0001 | 29 (20.4) | 32 (22.5) | 0.67 | ||
| Active neoplastic disease | 7 (0.6) | 16 (6.5) | < 0.0001 | 5 (3.5) | 5 (3.5) | 1.00 | ||
| Oxygen dependency | 8 (0.7) | 25 (10.0) | < 0.0001 | 3 (2.1) | 4 (2.8) | 0.71 | ||
| Critical preoperative status | 13 (1.1) | 5 (2.0) | 0.22 | 5 (3.5) | 3 (2.1) | 0.48 | ||
| Prior aorto-iliac surgery | 31 (2.6) | 9 (3.6) | 0.36 | 5 (3.5) | 4 (2.8) | 0.74 | ||
| Prior cardiac surgery | 43 (2.5) | 29 (11.6) | < 0.0001 | 11 (7.7) | 12 (8.5) | 0.83 | ||
| EuroSCORE II [%] | 2.7 ±3.1 | 5.5 ±5.4 | < 0.0001 | 4.7 ±5.8 | 4.5 ±4.7 | 0.73 | ||
Data are reported as mean and standard deviation or counts and percentages. †Child-Pugh class B or C. SAVR – surgical aortic valve replacement, TAVI – transcatheter aortic valve implantation, BMI – body mass index, LVEF – left ventricle ejection fraction, NYHA – New York Heart Association, CAD – coronary artery disease, AMI – acute myocardial infarction, PCI – percutaneous coronary intervention, BAV – balloon aortic valvuloplasty, COPD – chronic obstructive pulmonary disease, eGFR – estimated glomerular filtration rate.