Ethnic disparities and outcomes of Edwards SAPIEN transcatheter aortic valve implantation in Kuwait : A single-center pilot study

Introduction: Clinical outcomes after transcatheter aortic valve implantation (TAVI) have not been reported in the Gulf region. This study aims to identify baseline characteristics of patients undergoing TAVI, based on nationality, and analyze their overall outcomes at a single center in Kuwait. Methods: A retrospective study of 61 patients with severe aortic stenosis undergoing TAVI between 2018 and 2021 in Sabah Al Ahmad Cardiac Centre in Kuwait. Clinical and baseline demographics data along with preprocedural computed tomography (CT) and echocardiography were reviewed. Postprocedural outcomes, including conduction disturbances and inhospital mortality rates, were analyzed. Patients were analyzed according to Kuwaiti and non-Kuwaiti citizens\u27 status. Results: The mean age of Kuwaiti patients was 72.2 ± 9.2, whereas the mean age of non-Kuwaiti citizens was 78.8 ± 5.5. No significant differences were observed between Kuwaiti and non-Kuwaiti in electrocardiogram (ECG) and CT parameters ( P \u3e 0.05). A statistically significant difference among Kuwaiti and non-Kuwaiti patients was observed only laboratory parameters, white blood cell (WBC) count, international normalized ratio (INR), and C-reactive protein (CRP). The mean value of WBC count (WBC), INR, and CRP was higher among non-Kuwaiti patients when compared to Kuwaiti patients ( P \u3c 0.05). Inhospital mortality was low 1/61 (1.6%). Conclusion: Cumulative inhospital mortality in TAVI was 1.6%. TAVI experience in Kuwait with Edwards SAPIEN valve is comparable to international cohorts. No significant differences in procedural outcomes, including conduction disturbance and mortality, were observed between the two subgroups

Morbidity and mortality of acute heart failure patients stratified by mitral regurgitation in the Arabian Gulf: Observations from the Gulf acute heart failure registry (Gulf CARE)

This study aimed to evaluate the clinical outcomes of patients with acute heart failure (AHF) stratified by mitral regurgitation (MR) in the Arabian Gulf. Patients from the Gulf CARE registry were identified from 47 hospitals in seven Arabian Gulf countries (Yemen, Oman, Kuwait, Qatar, Bahrain, the United Arab Emirates, and Saudi Arabia) from February to November 2012. The cohort was stratified into two groups based on the presence of MR. Univariable and multivariable statistical analyses were performed. The population cohort included 5005 consecutive patients presenting with AHF, of whom 1491 (29.8 %) had concomitant MR. The mean age of patients with AHF and concomitant MR was 59.2 ± 14.9 years, and 63.1 % (n = 2886) were male. A total of 58.6 % (n = 2683) had heart failure (HF) with reduced ejection fraction (EF) (HFrEF), 21.0 % (n = 961) had HF with mildly reduced EF (HFmrEF), and 20.4 % (n = 932) had HF with preserved EF (HFpEF). Patients with MR had a lower haemoglobin (Hb) level (12.4 vs. 12.7 g/dL; p < 0.001), and a higher prevalence of left atrial enlargement (80.2 % vs. 55.1 %; p < 0.001), cardiogenic shock (9.7 % vs. 7.3 %; p = 0.006) and atrial fibrillation (7.6 % vs. 5.6 %; p = 0.006), and HFrEF (71.0 % vs. 52.6 %; P < 0.001). Multivariable analysis demonstrated that MR was independently associated with increased all-cause mortality at 1-year and 3-month HF rehospitalization [1-year all-cause mortality, adjusted odds ratio (aOR), 1.40; 95 % confidence interval (Cl): 1.13–1.74; p = 0.002; 3-month HF rehospitalization, aOR, 1.26; 95 % Cl: 1.06–1.49; p = 0.009]. In an Arabian Gulf cohort with AHF, concomitant MR was associated with an increased risk of 1-year mortality and 3-months HF rehospitalization