Incidence, clinical impact and predictors of thrombocytopenia after transcatheter aortic valve replacement

Thrombocytopenia is a common, yet poorly understood, complication after transcatheter aortic valve replacement (TAVR). Balloon-expandable transcatheter heart valve has been associated with higher incidence of thrombocytopenia, compared with self-expandable valves. The aim of this study was to analyz...

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Published in:International journal of cardiology 2022-04, Vol.352, p.21-26
Main Authors: Tirado-Conte, Gabriela, Salazar, Carlos H., McInerney, Angela, Cruz-Utrilla, Alejandro, Jiménez-Quevedo, Pilar, Cobiella, Javier, Gonzalo, Nieves, Carnero, Manuel, Núñez-Gil, Iván, Mejía-Rentería, Hernán, Salinas, Pablo, Macaya, Fernando, Maroto, Luis C., Vilacosta, Isidre, Fernández-Ortiz, Antonio, Escaned, Javier, Macaya, Carlos, Nombela-Franco, Luis
Format: Article
Language:English
Subjects:
Aortic Valve - surgery
Aortic Valve Stenosis
Heart Valve Prosthesis - adverse effects
Humans
Incidence
Platelets
Retrospective Studies
Risk Factors
TAVI
TAVR
Thrombocytopenia
Thrombocytopenia - diagnosis
Thrombocytopenia - epidemiology
Thrombocytopenia - etiology
Transcatheter Aortic Valve Replacement - adverse effects
Treatment Outcome
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Summary:Thrombocytopenia is a common, yet poorly understood, complication after transcatheter aortic valve replacement (TAVR). Balloon-expandable transcatheter heart valve has been associated with higher incidence of thrombocytopenia, compared with self-expandable valves. The aim of this study was to analyze the incidence, clinical impact and predictors of acquired thrombocytopenia in patients undergoing TAVR. We performed an observational study from consecutive patients with severe aortic stenosis undergoing TAVR (n = 679) in a single center. Association and best cut-off point of platelet decrease with early mortality was analyzed. Patients were classified according to postprocedural percentage decrease in platelet count (PDPC), comparing clinical outcomes and analyzing predictors of platelet decrease. The median PDPC was 37.1 [IQR: 27.4–46.9]. PDPC was associated with early mortality (OR: 2.1, 95%IC: 1.7–2.5 for each 10% decrease, AUC:0.81, 95%CI:0.72–0.89) with an optimal cut-off point of 46%. PDPC≥46% and late nadir (≥4 days) were both independent predictors of early mortality (OR: 6.0 [IQR: 2.4–14.9] and OR: 5.1 [IQR: 2.2–11.6], respectively). The combination of both factors (PDPC≥46% and nadir ≥4 day) was associated with higher 2-year mortality (55.7%) compared to an early significant nadir (PDPC≥46% and nadir
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2022.01.072