Impact on prognosis of periprocedural bleeding after TAVI: mid-term follow-up of a multicenter prospective study

Autor:	Moretti, C, D'Amico, M, D'Ascenzo, F, Colaci, C, Salizzoni, S, Tamburino, Corrado, Presbitero, P, Marra, S, Sheiban, I, Gaita, F.
Rok vydání:	2014
Předmět:	Aged 80 and over Male Time Factors Blood Loss Surgical Aortic Valve Stenosis Acute Kidney Injury Postoperative Hemorrhage Prognosis Risk Assessment Severity of Illness Index Transcatheter Aortic Valve Replacement Italy Risk Factors Humans Female Prospective Studies Aged Follow-Up Studies Glomerular Filtration Rate
Zdroj:	Journal of interventional cardiology. 27(3)
ISSN:	1540-8183
Popis:	Impact of periprocedural bleeding after transcatheter aortic valve implantation (TAVI) over mid-term prognosis remains still unclear.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.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%).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.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::79cc1e71ed10aa4ead0bc59088eeda08 https://pubmed.ncbi.nlm.nih.gov/24701998 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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