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Seiffert, Moritz; Conradi, Lenard; Gutwein, Andreas; Schön, Gerhard; Deuschl, Florian; Schofer, Niklas; Becker, Nina; Schirmer, Johannes; Reichenspurner, Hermann; Blankenberg, Stefan; Treede, Hendrik; Schäfer, Ulrich

Baseline anemia and its impact on midterm outcome after transcatheter aortic valve implantation

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  • Medientyp: E-Artikel
  • Titel: Baseline anemia and its impact on midterm outcome after transcatheter aortic valve implantation
  • Beteiligte: Seiffert, Moritz; Conradi, Lenard; Gutwein, Andreas; Schön, Gerhard; Deuschl, Florian; Schofer, Niklas; Becker, Nina; Schirmer, Johannes; Reichenspurner, Hermann; Blankenberg, Stefan; Treede, Hendrik; Schäfer, Ulrich
  • Erschienen: Wiley, 2017
  • Erschienen in: Catheterization and Cardiovascular Interventions
  • Sprache: Englisch
  • DOI: 10.1002/ccd.26563
  • ISSN: 1522-1946; 1522-726X
  • Schlagwörter: Cardiology and Cardiovascular Medicine ; Radiology, Nuclear Medicine and imaging ; General Medicine
  • Entstehung:
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  • Beschreibung: <jats:sec><jats:title>Background</jats:title><jats:p>Anemia is linked to impaired outcome in patients with cardiovascular diseases. We sought to characterize the impact of baseline anemia on mid‐term outcome after transcatheter aortic valve implantation (TAVI).</jats:p></jats:sec><jats:sec><jats:title>Methods and results</jats:title><jats:p>Data of 1201 consecutive TAVI patients were retrospectively analyzed. Baseline anemia was defined according to the WHO (hemoglobin &lt;12g/dl [female], &lt;13g/dl [male]). It was prevalent in 59.0% of patients and associated with a higher preoperative risk (STS‐PROM 7.8 ± 5.7 vs. 6.2 ± 4.1%, <jats:italic>P</jats:italic> &lt; 0.001). Survival was similar at 30 days (90.5 vs. 91.2%, <jats:italic>P</jats:italic> = 0.626) but NYHA functional capacity was impaired in patients with baseline anemia (classes III/IV: 20.6 vs. 15.6%, <jats:italic>P</jats:italic> = 0.006). Low baseline hemoglobin (OR 0.85, CI 0.73–0.98, <jats:italic>P</jats:italic> = 0.025), blood transfusion (OR 2.42, CI 1.38–4.28, <jats:italic>P</jats:italic> = 0.002), and bleeding complications (OR 2.21, CI 1.27‐3.81, <jats:italic>P</jats:italic> = 0.005) were in addition associated with acute kidney injury after TAVI. Three‐year survival was reduced (49.6 vs. 64.9%, <jats:italic>P</jats:italic> = 0.002) and baseline anemia was linked to increased mid‐term mortality (HR 1.43, CI 1.13–1.82, <jats:italic>P</jats:italic> = 0.003), however its effect was surpassed by the adverse impact of periprocedural complications. <jats:italic>Conclusions</jats:italic>: Baseline anemia was associated with increased morbidity and mortality after TAVI. Preprocedural hemoglobin levels need to be assessed for risk stratification and blood conservation management seems essential. As a potentially modifiable target, the role of pretreatment of anemia prior to TAVI remains to be determined. © 2016 Wiley Periodicals, Inc.</jats:p></jats:sec>