| Transcatheter aortic valve implantation and bleeding: incidence, predictors and prognosis. | |
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MedLine Citation:
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PMID: 23143652 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Peri-procedural bleeding complications are feared adverse events in patients undergoing transcatheter aortic valve implantation (TAVI). Little is known about the implications of peri-procedural bleeding on clinical outcome. In a prospective single-center registry of consecutive patients undergoing TAVI, we investigated incidence, predictors and clinical consequences of life-threatening and major bleeding as defined by the Valve Academic Research Consortium. Among 389 consecutive patients undergoing TAVI by a transfemoral (79.2 %), transapical (19.6 %) or trans-subclavian (1.3 %) approach between July 2007 and October 2011, life-threatening or major peri-procedural bleeding events occurred in 64 (16.4 %) and 125 patients (32.1 %), respectively. Patients with peri-procedural bleeding events had a higher logistic EuroSCORE, more advanced renal disease, and were more symptomatic as assessed by New York Heart Association functional class at baseline as compared to patients with no bleeding. Life-threatening bleeding was associated with a higher all-cause (17.2 vs 5.6 vs 3.0 %, p < 0.001) and cardiovascular mortality (10.9 vs 5.6 vs 2.5 %, p = 0.02) at 30 days compared to patients with major bleeding or no bleeding. Multivariate analysis identified transapical access (OR 2.6, 95 % CI 1.4-4.8; p = 0.002), glomerular filtration rate <30 ml/min (OR 2.3, 95 % CI 1.1-4.7, p = 0.031), and diabetes (OR 1.8, 95 % CI 1.001-3.2, p = 0.049) as independent predictors of life-threatening, peri-procedural bleeding. Life-threatening bleeding complications in patients undergoing TAVI are associated with increased mortality. Renal impairment, diabetes, and transapical approach were identified as independent risk factors for life-threatening bleeding events. |
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Authors:
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Thomas Pilgrim; Stefan Stortecky; Fabienne Luterbacher; Stephan Windecker; Peter Wenaweser |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-10 |
Journal Detail:
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Title: Journal of thrombosis and thrombolysis Volume: - ISSN: 1573-742X ISO Abbreviation: J. Thromb. Thrombolysis Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9502018 Medline TA: J Thromb Thrombolysis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, Bern, Switzerland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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