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

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)50-59
Number of pages10
JournalActa Cardiologica
Volume73
Issue number1
DOIs
Publication statusPublished - Feb 2018

Fingerprint

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

Cite this

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 journalArticle

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. 2018 ; Vol. 73, No. 1. pp. 50-59.
@article{fa1b853a952f47af952c705e6b48d79e,
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",
year = "2018",
month = "2",
doi = "10.1080/00015385.2017.1327627",
language = "English",
volume = "73",
pages = "50--59",
journal = "Acta Cardiologica",
issn = "0001-5385",
publisher = "Acta Cardiologica",
number = "1",

}

TY - JOUR

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 -