Blood transfusion is associated with impaired outcome after transcatheter aortic valve implantation
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Blood transfusion is associated with impaired outcome after transcatheter aortic valve implantation. / Seiffert, Moritz; Conradi, Lenard; Terstesse, Ann Christine; Koschyk, Dietmar; Schirmer, Johannes; Schnabel, Renate B; Wilde, Sandra; Ojeda, Francisco M; Reichenspurner, Hermann; Blankenberg, Stefan; Schäfer, Ulrich; Treede, Hendrik; Diemert, Patrick.
In: CATHETER CARDIO INTE, Vol. 85, No. 3, 15.02.2015, p. 460-467.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Blood transfusion is associated with impaired outcome after transcatheter aortic valve implantation
AU - Seiffert, Moritz
AU - Conradi, Lenard
AU - Terstesse, Ann Christine
AU - Koschyk, Dietmar
AU - Schirmer, Johannes
AU - Schnabel, Renate B
AU - Wilde, Sandra
AU - Ojeda, Francisco M
AU - Reichenspurner, Hermann
AU - Blankenberg, Stefan
AU - Schäfer, Ulrich
AU - Treede, Hendrik
AU - Diemert, Patrick
N1 - © 2014 Wiley Periodicals, Inc.
PY - 2015/2/15
Y1 - 2015/2/15
N2 - OBJECTIVES: We sought to evaluate the relationship of blood transfusion after transcatheter aortic valve implantation (TAVI) and mid-term outcome to improve patient selection and periprocedural treatment.BACKGROUND: Increasing evidence suggests a negative influence of blood transfusion on outcomes of patients with cardiovascular diseases. While the adverse impact of bleeding events on survival has been documented after TAVI, data on the impact of postoperative blood transfusions are scarce.METHODS: TAVI was performed in 700 consecutive patients; 14.7% of TAVI patients suffered from bleeding or access site complications and were excluded from analysis to minimize confounding. Outcomes were analyzed with emphasis on blood transfusions and according to the Valve Academic Research Consortium definitions. Median follow-up duration was 364 days. Multivariable analyses were performed to identify predictors for transfusion and 1-year mortality.RESULTS: 33.0% of patients received blood transfusions after TAVI, irrespective of access choice. Blood transfusions were associated with a higher baseline risk profile (median logistic EuroSCORE 21.0 vs. 17.0%), increased rates of postoperative complications and impaired survival (21.2 vs. 36.1% all-cause 1-year mortality). Transfusion was an independent predictor of mortality at 1 year (OR 2.78 [CI 1.59-4.86]). Low body mass index (OR 0.94 [0.89-1.0]), low baseline hemoglobin (OR 0.39 [0.33-0.47]) and combined anticoagulation/antiplatelet therapy were identified as independent predictors of blood transfusion after TAVI.CONCLUSIONS: Blood transfusions were frequently required after TAVI even in the absence of overt bleeding or access site complications and were identified as an independent predictor of impaired mid-term outcome. Optimization of baseline factors, strict blood conservation strategies, and individualized antiplatelet or anticoagulant regimens may improve outcome after TAVI.
AB - OBJECTIVES: We sought to evaluate the relationship of blood transfusion after transcatheter aortic valve implantation (TAVI) and mid-term outcome to improve patient selection and periprocedural treatment.BACKGROUND: Increasing evidence suggests a negative influence of blood transfusion on outcomes of patients with cardiovascular diseases. While the adverse impact of bleeding events on survival has been documented after TAVI, data on the impact of postoperative blood transfusions are scarce.METHODS: TAVI was performed in 700 consecutive patients; 14.7% of TAVI patients suffered from bleeding or access site complications and were excluded from analysis to minimize confounding. Outcomes were analyzed with emphasis on blood transfusions and according to the Valve Academic Research Consortium definitions. Median follow-up duration was 364 days. Multivariable analyses were performed to identify predictors for transfusion and 1-year mortality.RESULTS: 33.0% of patients received blood transfusions after TAVI, irrespective of access choice. Blood transfusions were associated with a higher baseline risk profile (median logistic EuroSCORE 21.0 vs. 17.0%), increased rates of postoperative complications and impaired survival (21.2 vs. 36.1% all-cause 1-year mortality). Transfusion was an independent predictor of mortality at 1 year (OR 2.78 [CI 1.59-4.86]). Low body mass index (OR 0.94 [0.89-1.0]), low baseline hemoglobin (OR 0.39 [0.33-0.47]) and combined anticoagulation/antiplatelet therapy were identified as independent predictors of blood transfusion after TAVI.CONCLUSIONS: Blood transfusions were frequently required after TAVI even in the absence of overt bleeding or access site complications and were identified as an independent predictor of impaired mid-term outcome. Optimization of baseline factors, strict blood conservation strategies, and individualized antiplatelet or anticoagulant regimens may improve outcome after TAVI.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve
KW - Blood Transfusion/mortality
KW - Cardiac Catheterization/adverse effects
KW - Female
KW - Germany
KW - Heart Valve Diseases/diagnosis
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Hemorrhage/diagnosis
KW - Humans
KW - Kaplan-Meier Estimate
KW - Logistic Models
KW - Male
KW - Multivariate Analysis
KW - Odds Ratio
KW - Patient Selection
KW - Retrospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
KW - Transfusion Reaction
KW - Treatment Outcome
U2 - 10.1002/ccd.25691
DO - 10.1002/ccd.25691
M3 - SCORING: Journal article
C2 - 25292388
VL - 85
SP - 460
EP - 467
JO - CATHETER CARDIO INTE
JF - CATHETER CARDIO INTE
SN - 1522-1946
IS - 3
ER -
