Early Adverse Impact of Transfusion After Transcatheter Aortic Valve Replacement
| Autor: | Giulio G. Stefanini, Elisa Nicolini, Bernhard Reimers, Tania Rodriguez-Gabella, Andrea Picchi, Ignacio J. Amat-Santos, Carolina Moretti, Corrado Tamburino, Francesco Bedogni, Carlo De Innocentiis, Francesco Saia, Tommaso Piva, Marco Zimarino, Michele Marchioni, Francesco Radico, Sabina Gallina, Nicola Maddestra, Alessandro Toro, George Dangas, Davide Capodanno, Luca Testa, Marco Barbanti |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Transcatheter aortic business.industry medicine.medical_treatment Acute kidney injury Aortic Valve Stenosis medicine.disease Surgery Transcatheter Aortic Valve Replacement Red blood cell Postoperative Complications Treatment Outcome medicine.anatomical_structure Valve replacement Risk Factors Aortic Valve medicine Humans Registries Cardiology and Cardiovascular Medicine business Retrospective Studies |
| Zdroj: | Circulation: Cardiovascular Interventions. 13 |
| ISSN: | 1941-7632 1941-7640 |
| DOI: | 10.1161/circinterventions.120.009026 |
| Popis: | Background: There is no consensus on the benefit of red blood cell (RBC) transfusion after transcatheter aortic valve replacement. Methods: The multicenter Transfusion Requirements in Transcatheter Aortic Valve Implantation (TRITAVI) registry retrospectively included patients after transfemoral transcatheter aortic valve replacement; propensity score-matching identified pairs of patients with and without RBC transfusion. The primary end point was 30-day mortality; nonfatal myocardial infarction, cerebrovascular accident, and stage 2 to 3 acute kidney injury at 30 days were secondary end points. We repeated propensity score-matching according to the hemoglobin nadir, hemoglobin drop, and in the subgroup of uncomplicated patients, without major vascular complications or major bleeding. Results: Among 2587 patients, RBC transfusion was administered in 421 cases (16%). The primary end point occurred in 104 (4.0%) patients, myocardial infarction in 9 (0.4%), cerebrovascular accident in 38 (1.5%), and acute kidney injury in 125 (4.8%) cases. In the 842 propensity-matched patients, RBC transfusion was associated with increased mortality (hazard ratio, 2.07 [95% CI, 1.06–4.05]; P =0.034) and acute kidney injury (hazard ratio, 4.35 [95% CI, 2.21–8.55]; P P =0.044), major bleeding ( P =0.041), and RBC transfusion ( P =0.048) were independent correlates of 30-day mortality. Conclusions: RBC transfusion correlates with increased mortality and acute kidney injury early after transcatheter aortic valve replacement and is an independent predictor of 30-day mortality, irrespective of periprocedural major bleeding and vascular complications. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03740425. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|