Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia

Paola D’Errigo, Fausto Biancari, Stefano Rosato, Corrado Tamburino, Marco Ranucci, Gennaro Santoro, Marco Barbanti, Martina Ventura, Danilo Fusco, Fulvia Seccareccia

Research output: Contribution to journalArticle

Abstract

© 2017 Belgian Society of Cardiology Objectives: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. Methods: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis. Results: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1.37, 95% CI 1.12–1.68) and SAVR (HR 1.63, 95% CI 1.37–1.99). Propensity score matching resulted in 302 pairs with similar characteristics. Patients undergoing SAVR had similar 30-d mortality (3.6% versus 3.3%, p = .81) and stroke (1.3% versus 2.0%, p = .53) compared with TAVI. The rates of pacemaker implantation (18.6% versus 3.0%, p  < .001), major vascular damage (5.7% versus 0.4%, p  < .001) and mild-to-severe paravalvular regurgitation (47.4% versus 9.3%, p  < .001) were higher after TAVI, whereas acute kidney injury (50.7% versus 27.9%, p  < .001) and blood transfusion (70.0% versus 38.6%, p  < .001) were more frequent after SAVR. At 3-year, survival was 74.0% after SAVR and 66.3% after TAVI, respectively (p = .065), and freedom from MACCE was 67.6% after SAVR and 58.7% after TAVI, respectively (p = .049). Conclusions: These results suggest that TAVI is not superior to SAVR in patients with anaemia.
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalActa Cardiologica
DOIs
Publication statusAccepted/In press - Jul 25 2017

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Aortic Valve
Surgical Instruments
Anemia
Propensity Score
Mortality
Transcatheter Aortic Valve Replacement
Aortic Valve Stenosis
Acute Kidney Injury
Blood Transfusion
Blood Vessels
Hemoglobins
Stroke
Survival

Keywords

  • Anaemia
  • anaemic
  • aortic valve replacement
  • aortic valve stenosis
  • TAVI
  • TAVR

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Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia. / D’Errigo, Paola; Biancari, Fausto; Rosato, Stefano; Tamburino, Corrado; Ranucci, Marco; Santoro, Gennaro; Barbanti, Marco; Ventura, Martina; Fusco, Danilo; Seccareccia, Fulvia.

In: Acta Cardiologica, 25.07.2017, p. 1-10.

Research output: Contribution to journalArticle

D’Errigo, P, Biancari, F, Rosato, S, Tamburino, C, Ranucci, M, Santoro, G, Barbanti, M, Ventura, M, Fusco, D & Seccareccia, F 2017, 'Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia', Acta Cardiologica, pp. 1-10. https://doi.org/10.1080/00015385.2017.1327627
D’Errigo, Paola ; Biancari, Fausto ; Rosato, Stefano ; Tamburino, Corrado ; Ranucci, Marco ; Santoro, Gennaro ; Barbanti, Marco ; Ventura, Martina ; Fusco, Danilo ; Seccareccia, Fulvia. / Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia. In: Acta Cardiologica. 2017 ; pp. 1-10.
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abstract = "{\circledC} 2017 Belgian Society of Cardiology Objectives: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. Methods: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis. Results: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1.37, 95{\%} CI 1.12–1.68) and SAVR (HR 1.63, 95{\%} CI 1.37–1.99). Propensity score matching resulted in 302 pairs with similar characteristics. Patients undergoing SAVR had similar 30-d mortality (3.6{\%} versus 3.3{\%}, p = .81) and stroke (1.3{\%} versus 2.0{\%}, p = .53) compared with TAVI. The rates of pacemaker implantation (18.6{\%} versus 3.0{\%}, p  < .001), major vascular damage (5.7{\%} versus 0.4{\%}, p  < .001) and mild-to-severe paravalvular regurgitation (47.4{\%} versus 9.3{\%}, p  < .001) were higher after TAVI, whereas acute kidney injury (50.7{\%} versus 27.9{\%}, p  < .001) and blood transfusion (70.0{\%} versus 38.6{\%}, p  < .001) were more frequent after SAVR. At 3-year, survival was 74.0{\%} after SAVR and 66.3{\%} after TAVI, respectively (p = .065), and freedom from MACCE was 67.6{\%} after SAVR and 58.7{\%} after TAVI, respectively (p = .049). Conclusions: These results suggest that TAVI is not superior to SAVR in patients with anaemia.",
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AU - D’Errigo, Paola

AU - Biancari, Fausto

AU - Rosato, Stefano

AU - Tamburino, Corrado

AU - Ranucci, Marco

AU - Santoro, Gennaro

AU - Barbanti, Marco

AU - Ventura, Martina

AU - Fusco, Danilo

AU - Seccareccia, Fulvia

PY - 2017/7/25

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N2 - © 2017 Belgian Society of Cardiology Objectives: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. Methods: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis. Results: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1.37, 95% CI 1.12–1.68) and SAVR (HR 1.63, 95% CI 1.37–1.99). Propensity score matching resulted in 302 pairs with similar characteristics. Patients undergoing SAVR had similar 30-d mortality (3.6% versus 3.3%, p = .81) and stroke (1.3% versus 2.0%, p = .53) compared with TAVI. The rates of pacemaker implantation (18.6% versus 3.0%, p  < .001), major vascular damage (5.7% versus 0.4%, p  < .001) and mild-to-severe paravalvular regurgitation (47.4% versus 9.3%, p  < .001) were higher after TAVI, whereas acute kidney injury (50.7% versus 27.9%, p  < .001) and blood transfusion (70.0% versus 38.6%, p  < .001) were more frequent after SAVR. At 3-year, survival was 74.0% after SAVR and 66.3% after TAVI, respectively (p = .065), and freedom from MACCE was 67.6% after SAVR and 58.7% after TAVI, respectively (p = .049). Conclusions: These results suggest that TAVI is not superior to SAVR in patients with anaemia.

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KW - aortic valve replacement

KW - aortic valve stenosis

KW - TAVI

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