期刊
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
卷 89, 期 1, 页码 E44-E52出版社
WILEY
DOI: 10.1002/ccd.26563
关键词
TAVI; hemoglobin; blood transfusion; acute kidney injury
BackgroundAnemia 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). Methods and resultsData of 1201 consecutive TAVI patients were retrospectively analyzed. Baseline anemia was defined according to the WHO (hemoglobin <12g/dl [female], <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%, P<0.001). Survival was similar at 30 days (90.5 vs. 91.2%, P=0.626) but NYHA functional capacity was impaired in patients with baseline anemia (classes III/IV: 20.6 vs. 15.6%, P=0.006). Low baseline hemoglobin (OR 0.85, CI 0.73-0.98, P=0.025), blood transfusion (OR 2.42, CI 1.38-4.28, P=0.002), and bleeding complications (OR 2.21, CI 1.27-3.81, P=0.005) were in addition associated with acute kidney injury after TAVI. Three-year survival was reduced (49.6 vs. 64.9%, P=0.002) and baseline anemia was linked to increased mid-term mortality (HR 1.43, CI 1.13-1.82, P=0.003), however its effect was surpassed by the adverse impact of periprocedural complications. Conclusions: 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. (c) 2016 Wiley Periodicals, Inc.
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