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Impact on Prognosis of Periprocedural Bleeding after TAVI: Mid-Term Follow-Up of a Multicenter Prospective Study.
- Source :
- Journal of Interventional Cardiology; Jun2014, Vol. 27 Issue 3, p293-299, 7p
- Publication Year :
- 2014
-
Abstract
- Aims Impact of periprocedural bleeding after transcatheter aortic valve implantation (TAVI) over mid-term prognosis remains still unclear. Methods Consecutive patients who underwent TAVI from May 2008 to July 2012 were prospectively included and stratified according to life-threatening (LT) and major bleeding (MB). Mid-term all-cause death was the primary end-point, and 30-day death, vascular complications, stroke, and acute kidney injury the secondary ones. All end-points were adjudicated according to VARC. Results Seven hundred fourteen patients with an average age of 81.9 ± 5.8 years were included. 130 (18%) patients suffered a LT, 112 (16%) a MB. A preprocedural GFR <30 ml/min and increasing diameter of sheaths were independent predictors of LT or MB, while transfemoral approach showed a protective effect (OR 0.42; CI: 0.26-0.68; P = 0.035). At 30 days LT (OR 3.3; CI: 1.1-9.7; P = 0.0026) and MB (OR 3.5; CI: 1.4-8.6; P = 0.007) bleeding along with GFR < 30 ml/min (OR 2.3; CI: 1.1-5.5; P = 0.04) were independent predictors of death, while bleeding did not impact survival on mid term (OR 0.9; CI: 0.47-1.7; P = 0.78; all CI 95%). Conclusion Periprocedural bleeding after TAVI was frequent and associated with an increased mortality after 30 days but not after mid-term follow-up. A preprocedural GFR < 30 ml/min was the most important predictor of bleeding, enabling risk stratification and choice of approach for these patients. (J Interven Cardiol 2014;27:293-299) [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08964327
- Volume :
- 27
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Journal of Interventional Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 96325262
- Full Text :
- https://doi.org/10.1111/joic.12115