Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry.

Abstract

OBJECTIVES:

To assess the impact of anemia on clinical outcomes in female patients enrolled in the Women's InterNational transcatheter aortic valve implantation (WIN-TAVI) registry.

BACKGROUND:

Anemia is highly prevalent among females who constitute half of TAVI candidates, yet, its clinical significance remains poorly investigated.

METHODS:

Patients were divided into three groups according to preprocedural hemoglobin (Hb) level: (1) no anemia (Hb ≥12 g/dl), (2) mild-to-moderate anemia (10 ≤ Hb <12 g/dl), and (3) severe anemia (Hb <10 g/dl). The primary outcome was the occurrence of Valve Academic Research Consortium (VARC)-2 efficacy endpoint, a composite of mortality, stroke, myocardial infarction (MI), hospitalization for valve-related symptoms or heart failure or valve-related dysfunction at 1-year follow-up.

RESULTS:

Hemoglobin level was available in 877 (86.1%) patients: 412 (47.0%) had no anemia, 363 (41.4%) had mild-to-moderate anemia, and 102 (11.6%) had severe anemia. The latter group had a higher prevalence of cardiovascular risk factors. Compared with patients without anemia, severe anemia was associated with a greater risk of VARC-2 efficacy endpoint (adj HR 1.71, 95% CI: 1.02-2.87, p = .04), all-cause death (adj HR 2.36, 95% CI: 1.31-4.26, p = .004) and a composite of death, MI or stroke (adj HR 1.88, 95% CI: 1.10-3.22, p = .02) at 1 year. Moreover, an increased risk of late mortality (adj HR 1.15, 95% CI: 1.02-1.30, p = .03) was observed with every 1 g/dl decrease in hemoglobin level.

CONCLUSION:

Severe anemia in females undergoing TAVI was independently associated with increased rates of VARC-2 efficacy endpoint and mortality at 1 year.

• Authors: Johny Nicolas, Bimmer E Claessen, Davide Cao, Samantha Sartori, Usman Baber, David Power, Mauro Chiarito, Ridhima Goel, Anastasios Roumeliotis, Rishi Chandiramani, Siyan Chen, Jaya Chandrasekhar, Didier Tchetche, Anna Sonia Petronio, Julinda Mehilli, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Emanuele Meliga, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Maria-Cruz Ferrer-Gracia, Christoph Naber, Samin Sharma, Marie-Claude Morice, George D Dangas, Alaide Chieffo, Roxana Mehran
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 97 Issue 5 Pg. E704-E715 (04 01 2021) ISSN: 1522-726X [Electronic] United States
• PMID: 33002302 (Publication Type: Journal Article)
• Copyright: © 2020 Wiley Periodicals LLC.

Topics

• Anemia (epidemiology)
• Aortic Valve (diagnostic imaging, surgery)
• Aortic Valve Stenosis (diagnostic imaging, surgery)
• Female
• Heart Valve Prosthesis
• Heart Valve Prosthesis Implantation
• Humans
• Registries
• Risk Factors
• Transcatheter Aortic Valve Replacement (adverse effects)
• Treatment Outcome