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 (2017-08-16)
Paola D’Errigo, Fausto Biancari, Stefano Rosato, Corrado Tamburino, Marco Ranucci, Gennaro Santoro, Marco Barbanti, Martina Ventura, Danilo Fusco & Fulvia Seccareccia (2018) Transcatheter aortic valve implantation compared with surgical aortic valve replacement in patients with anaemia, Acta Cardiologica, 73:1, 50-59, DOI: 10.1080/00015385.2017.1327627
© Taylor & Francis 2017. This is an Accepted Manuscript of an article published by Taylor & Francis in Acta Cardiologica on 16.8.2017, available online: http://www.tandfonline.com/10.1080/00015385.2017.1327627.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2019101532710
Tiivistelmä
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.
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