Search

Your search keyword '"Benitez, Luis Miguel"' showing total 2 results
Start Over Author "Benitez, Luis Miguel" Publisher bmj pub. group
2 results on '"Benitez, Luis Miguel"'

1. Impact of anticoagulation therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement.

Author

UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Del Trigo, María, Muñoz-García, Antonio J, Latib, Azeem, Auffret, Vincent, Wijeysundera, Harindra C, Nombela-Franco, Luis, Gutierrez, Enrique, Cheema, Asim N, Serra, Vicenç, Amat-Santos, Ignacio J, Kefer, Joëlle, Benitez, Luis Miguel, Leclercq, Florence, Mangieri, Antonio, Le Breton, Hervé, Jiménez-Quevedo, Pilar, Garcia Del Blanco, Bruno, Dager, Antonio, Abdul-Jawad Altisent, Omar, Puri, Rishi, Pibarot, Philippe, Rodés-Cabau, Josep, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Del Trigo, María, Muñoz-García, Antonio J, Latib, Azeem, Auffret, Vincent, Wijeysundera, Harindra C, Nombela-Franco, Luis, Gutierrez, Enrique, Cheema, Asim N, Serra, Vicenç, Amat-Santos, Ignacio J, Kefer, Joëlle, Benitez, Luis Miguel, Leclercq, Florence, Mangieri, Antonio, Le Breton, Hervé, Jiménez-Quevedo, Pilar, Garcia Del Blanco, Bruno, Dager, Antonio, Abdul-Jawad Altisent, Omar, Puri, Rishi, Pibarot, Philippe, and Rodés-Cabau, Josep

Abstract

To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of anticoagulation therapy. This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P<0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P<0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up. The lack of anticoagulation therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic anticoagulation therapy post-TAVR would reduce the incidence of VHD.

Published
2018

2. Impact of anticoagulation therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement.

Author

Del Trigo M, Muñoz-García AJ, Latib A, Auffret V, Wijeysundera HC, Nombela-Franco L, Gutierrez E, Cheema AN, Serra V, Amat-Santos IJ, Kefer J, Benitez LM, Leclercq F, Mangieri A, Le Breton H, Jiménez-Quevedo P, Garcia Del Blanco B, Dager A, Abdul-Jawad Altisent O, Puri R, Pibarot P, and Rodés-Cabau J

Subjects
Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis physiopathology, Echocardiography methods, Europe epidemiology, Female, Follow-Up Studies, Heart Valve Prosthesis adverse effects, Humans, Kaplan-Meier Estimate, Male, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement methods, Treatment Outcome, Aortic Valve Stenosis surgery, Fibrinolytic Agents administration & dosage, Fibrinolytic Agents adverse effects, Hemodynamics drug effects, Postoperative Complications diagnosis, Postoperative Complications prevention & control, Thrombosis etiology, Thrombosis prevention & control
Abstract

Objective: To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of anticoagulation therapy., Methods and Results: This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P<0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P<0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up., Conclusions: The lack of anticoagulation therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic anticoagulation therapy post-TAVR would reduce the incidence of VHD., Competing Interests: Competing interests: PP has Core Lab contracts with Edwards Lifesciences for which he receives no direct compensation. R-C has received research grants from Edwards Lifesciences and Medtronic., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Published
2018
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results