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

doi:10.1080/00015385.2017.1327627

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 journal › Article › peer-review

Abstract

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 language	English
Pages (from-to)	50-59
Number of pages	10
Journal	Acta Cardiologica
Volume	73
Issue number	1
DOIs	https://doi.org/10.1080/00015385.2017.1327627
Publication status	Published - Feb 2018

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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, Vol. 73, No. 1, 02.2018, p. 50-59.

Research output: Contribution to journal › Article › peer-review

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title = "Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia",

abstract = "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.",

author = "Paola D'Errigo and Fausto Biancari and Stefano Rosato and Corrado Tamburino and Marco Ranucci and Gennaro Santoro and Marco Barbanti and Martina Ventura and Danilo Fusco and Fulvia Seccareccia",

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doi = "10.1080/00015385.2017.1327627",

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T1 - Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia

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 - 2018/2

Y1 - 2018/2

N2 - 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.

AB - 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.

U2 - 10.1080/00015385.2017.1327627

DO - 10.1080/00015385.2017.1327627

M3 - Article

C2 - 28812435

VL - 73

SP - 50

EP - 59

JO - Acta Cardiologica

JF - Acta Cardiologica

SN - 0001-5385

IS - 1

ER -