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 | |
| 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
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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 -