Transcatheter aortic valve implantation and bleeding: incidence, predictors and prognosis
Peri-procedural bleeding complications are feared adverse events in patients undergoing transcatheter aortic valve implantation (TAVI). Little is known about the implications of peri-procedural bleeding on clinical outcome. In a prospective single-center registry of consecutive patients undergoing T...
Gespeichert in:
| Veröffentlicht in: | Journal of thrombosis and thrombolysis 2013-05, Vol.35 (4), p.456-462 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 462 |
|---|---|
| container_issue | 4 |
| container_start_page | 456 |
| container_title | Journal of thrombosis and thrombolysis |
| container_volume | 35 |
| creator | Pilgrim, Thomas Stortecky, Stefan Luterbacher, Fabienne Windecker, Stephan Wenaweser, Peter |
| description | Peri-procedural bleeding complications are feared adverse events in patients undergoing transcatheter aortic valve implantation (TAVI). Little is known about the implications of peri-procedural bleeding on clinical outcome. In a prospective single-center registry of consecutive patients undergoing TAVI, we investigated incidence, predictors and clinical consequences of life-threatening and major bleeding as defined by the Valve Academic Research Consortium. Among 389 consecutive patients undergoing TAVI by a transfemoral (79.2 %), transapical (19.6 %) or trans-subclavian (1.3 %) approach between July 2007 and October 2011, life-threatening or major peri-procedural bleeding events occurred in 64 (16.4 %) and 125 patients (32.1 %), respectively. Patients with peri-procedural bleeding events had a higher logistic EuroSCORE, more advanced renal disease, and were more symptomatic as assessed by New York Heart Association functional class at baseline as compared to patients with no bleeding. Life-threatening bleeding was associated with a higher all-cause (17.2 vs 5.6 vs 3.0 %,
p
|
| doi_str_mv | 10.1007/s11239-012-0842-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1353043274</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1353043274</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-877d9fb3125584664888e4761862406e9b5dc42f3e055ec4711fd27c794187323</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMoWj9-gBdZ8OLB1XxuEm9S_IKCFwU9hTQ7W1O22ZpsC_57Y1tFBE8DM8-8MzwIHRN8QTCWl4kQynSJCS2x4rRkW2hAhGSl5PRlGw2wproUDIs9tJ_SFGOsNaa7aI8ywlkl6AC9PkUbkrP9G_QQC9vF3rtiadslFH42b23obe-7UNhQF-MWoPZhclX44HwNwcF5MY-55_ouphUzj90kdMmnQ7TT2DbB0aYeoOfbm6fhfTl6vHsYXo9Kx5nqSyVlrZsxI1QIxauKK6WAy4qoinJcgR6L2nHaMMBCgOOSkKam0knNiZKMsgN0ts7Nl98XkHoz88lBm1-HbpEMYdkAZ1TyjJ7-QafdIob83YrSQubUTJE15WKXUoTGzKOf2fhhCDZf3s3au8nezZd3w_LOySZ5MZ5B_bPxLToDdA2kPAoTiL9O_5v6CQbqjBI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1353957794</pqid></control><display><type>article</type><title>Transcatheter aortic valve implantation and bleeding: incidence, predictors and prognosis</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Pilgrim, Thomas ; Stortecky, Stefan ; Luterbacher, Fabienne ; Windecker, Stephan ; Wenaweser, Peter</creator><creatorcontrib>Pilgrim, Thomas ; Stortecky, Stefan ; Luterbacher, Fabienne ; Windecker, Stephan ; Wenaweser, Peter</creatorcontrib><description>Peri-procedural bleeding complications are feared adverse events in patients undergoing transcatheter aortic valve implantation (TAVI). Little is known about the implications of peri-procedural bleeding on clinical outcome. In a prospective single-center registry of consecutive patients undergoing TAVI, we investigated incidence, predictors and clinical consequences of life-threatening and major bleeding as defined by the Valve Academic Research Consortium. Among 389 consecutive patients undergoing TAVI by a transfemoral (79.2 %), transapical (19.6 %) or trans-subclavian (1.3 %) approach between July 2007 and October 2011, life-threatening or major peri-procedural bleeding events occurred in 64 (16.4 %) and 125 patients (32.1 %), respectively. Patients with peri-procedural bleeding events had a higher logistic EuroSCORE, more advanced renal disease, and were more symptomatic as assessed by New York Heart Association functional class at baseline as compared to patients with no bleeding. Life-threatening bleeding was associated with a higher all-cause (17.2 vs 5.6 vs 3.0 %,
p
< 0.001) and cardiovascular mortality (10.9 vs 5.6 vs 2.5 %,
p
= 0.02) at 30 days compared to patients with major bleeding or no bleeding. Multivariate analysis identified transapical access (OR 2.6, 95 % CI 1.4–4.8;
p
= 0.002), glomerular filtration rate <30 ml/min (OR 2.3, 95 % CI 1.1–4.7,
p
= 0.031), and diabetes (OR 1.8, 95 % CI 1.001–3.2,
p
= 0.049) as independent predictors of life-threatening, peri-procedural bleeding. Life-threatening bleeding complications in patients undergoing TAVI are associated with increased mortality. Renal impairment, diabetes, and transapical approach were identified as independent risk factors for life-threatening bleeding events.</description><identifier>ISSN: 0929-5305</identifier><identifier>EISSN: 1573-742X</identifier><identifier>DOI: 10.1007/s11239-012-0842-3</identifier><identifier>PMID: 23143652</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - physiopathology ; Aortic Valve Stenosis - therapy ; Blood Loss, Surgical - mortality ; Blood Loss, Surgical - physiopathology ; Cardiac Catheterization - adverse effects ; Cardiac Catheterization - instrumentation ; Cardiac Catheterization - methods ; Cardiology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; Hematology ; Humans ; Incidence ; Male ; Medicine ; Medicine & Public Health ; Postoperative Hemorrhage - etiology ; Postoperative Hemorrhage - mortality ; Postoperative Hemorrhage - physiopathology ; Registries ; Retrospective Studies ; Risk Factors ; Survival Rate</subject><ispartof>Journal of thrombosis and thrombolysis, 2013-05, Vol.35 (4), p.456-462</ispartof><rights>Springer Science+Business Media New York 2012</rights><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-877d9fb3125584664888e4761862406e9b5dc42f3e055ec4711fd27c794187323</citedby><cites>FETCH-LOGICAL-c438t-877d9fb3125584664888e4761862406e9b5dc42f3e055ec4711fd27c794187323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11239-012-0842-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11239-012-0842-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23143652$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pilgrim, Thomas</creatorcontrib><creatorcontrib>Stortecky, Stefan</creatorcontrib><creatorcontrib>Luterbacher, Fabienne</creatorcontrib><creatorcontrib>Windecker, Stephan</creatorcontrib><creatorcontrib>Wenaweser, Peter</creatorcontrib><title>Transcatheter aortic valve implantation and bleeding: incidence, predictors and prognosis</title><title>Journal of thrombosis and thrombolysis</title><addtitle>J Thromb Thrombolysis</addtitle><addtitle>J Thromb Thrombolysis</addtitle><description>Peri-procedural bleeding complications are feared adverse events in patients undergoing transcatheter aortic valve implantation (TAVI). Little is known about the implications of peri-procedural bleeding on clinical outcome. In a prospective single-center registry of consecutive patients undergoing TAVI, we investigated incidence, predictors and clinical consequences of life-threatening and major bleeding as defined by the Valve Academic Research Consortium. Among 389 consecutive patients undergoing TAVI by a transfemoral (79.2 %), transapical (19.6 %) or trans-subclavian (1.3 %) approach between July 2007 and October 2011, life-threatening or major peri-procedural bleeding events occurred in 64 (16.4 %) and 125 patients (32.1 %), respectively. Patients with peri-procedural bleeding events had a higher logistic EuroSCORE, more advanced renal disease, and were more symptomatic as assessed by New York Heart Association functional class at baseline as compared to patients with no bleeding. Life-threatening bleeding was associated with a higher all-cause (17.2 vs 5.6 vs 3.0 %,
p
< 0.001) and cardiovascular mortality (10.9 vs 5.6 vs 2.5 %,
p
= 0.02) at 30 days compared to patients with major bleeding or no bleeding. Multivariate analysis identified transapical access (OR 2.6, 95 % CI 1.4–4.8;
p
= 0.002), glomerular filtration rate <30 ml/min (OR 2.3, 95 % CI 1.1–4.7,
p
= 0.031), and diabetes (OR 1.8, 95 % CI 1.001–3.2,
p
= 0.049) as independent predictors of life-threatening, peri-procedural bleeding. Life-threatening bleeding complications in patients undergoing TAVI are associated with increased mortality. Renal impairment, diabetes, and transapical approach were identified as independent risk factors for life-threatening bleeding events.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve Stenosis - mortality</subject><subject>Aortic Valve Stenosis - physiopathology</subject><subject>Aortic Valve Stenosis - therapy</subject><subject>Blood Loss, Surgical - mortality</subject><subject>Blood Loss, Surgical - physiopathology</subject><subject>Cardiac Catheterization - adverse effects</subject><subject>Cardiac Catheterization - instrumentation</subject><subject>Cardiac Catheterization - methods</subject><subject>Cardiology</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis</subject><subject>Hematology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Postoperative Hemorrhage - etiology</subject><subject>Postoperative Hemorrhage - mortality</subject><subject>Postoperative Hemorrhage - physiopathology</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><issn>0929-5305</issn><issn>1573-742X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kE1LAzEQhoMoWj9-gBdZ8OLB1XxuEm9S_IKCFwU9hTQ7W1O22ZpsC_57Y1tFBE8DM8-8MzwIHRN8QTCWl4kQynSJCS2x4rRkW2hAhGSl5PRlGw2wproUDIs9tJ_SFGOsNaa7aI8ywlkl6AC9PkUbkrP9G_QQC9vF3rtiadslFH42b23obe-7UNhQF-MWoPZhclX44HwNwcF5MY-55_ouphUzj90kdMmnQ7TT2DbB0aYeoOfbm6fhfTl6vHsYXo9Kx5nqSyVlrZsxI1QIxauKK6WAy4qoinJcgR6L2nHaMMBCgOOSkKam0knNiZKMsgN0ts7Nl98XkHoz88lBm1-HbpEMYdkAZ1TyjJ7-QafdIob83YrSQubUTJE15WKXUoTGzKOf2fhhCDZf3s3au8nezZd3w_LOySZ5MZ5B_bPxLToDdA2kPAoTiL9O_5v6CQbqjBI</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Pilgrim, Thomas</creator><creator>Stortecky, Stefan</creator><creator>Luterbacher, Fabienne</creator><creator>Windecker, Stephan</creator><creator>Wenaweser, Peter</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130501</creationdate><title>Transcatheter aortic valve implantation and bleeding: incidence, predictors and prognosis</title><author>Pilgrim, Thomas ; Stortecky, Stefan ; Luterbacher, Fabienne ; Windecker, Stephan ; Wenaweser, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-877d9fb3125584664888e4761862406e9b5dc42f3e055ec4711fd27c794187323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve Stenosis - mortality</topic><topic>Aortic Valve Stenosis - physiopathology</topic><topic>Aortic Valve Stenosis - therapy</topic><topic>Blood Loss, Surgical - mortality</topic><topic>Blood Loss, Surgical - physiopathology</topic><topic>Cardiac Catheterization - adverse effects</topic><topic>Cardiac Catheterization - instrumentation</topic><topic>Cardiac Catheterization - methods</topic><topic>Cardiology</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Prosthesis</topic><topic>Hematology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Postoperative Hemorrhage - etiology</topic><topic>Postoperative Hemorrhage - mortality</topic><topic>Postoperative Hemorrhage - physiopathology</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pilgrim, Thomas</creatorcontrib><creatorcontrib>Stortecky, Stefan</creatorcontrib><creatorcontrib>Luterbacher, Fabienne</creatorcontrib><creatorcontrib>Windecker, Stephan</creatorcontrib><creatorcontrib>Wenaweser, Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thrombosis and thrombolysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pilgrim, Thomas</au><au>Stortecky, Stefan</au><au>Luterbacher, Fabienne</au><au>Windecker, Stephan</au><au>Wenaweser, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcatheter aortic valve implantation and bleeding: incidence, predictors and prognosis</atitle><jtitle>Journal of thrombosis and thrombolysis</jtitle><stitle>J Thromb Thrombolysis</stitle><addtitle>J Thromb Thrombolysis</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>35</volume><issue>4</issue><spage>456</spage><epage>462</epage><pages>456-462</pages><issn>0929-5305</issn><eissn>1573-742X</eissn><abstract>Peri-procedural bleeding complications are feared adverse events in patients undergoing transcatheter aortic valve implantation (TAVI). Little is known about the implications of peri-procedural bleeding on clinical outcome. In a prospective single-center registry of consecutive patients undergoing TAVI, we investigated incidence, predictors and clinical consequences of life-threatening and major bleeding as defined by the Valve Academic Research Consortium. Among 389 consecutive patients undergoing TAVI by a transfemoral (79.2 %), transapical (19.6 %) or trans-subclavian (1.3 %) approach between July 2007 and October 2011, life-threatening or major peri-procedural bleeding events occurred in 64 (16.4 %) and 125 patients (32.1 %), respectively. Patients with peri-procedural bleeding events had a higher logistic EuroSCORE, more advanced renal disease, and were more symptomatic as assessed by New York Heart Association functional class at baseline as compared to patients with no bleeding. Life-threatening bleeding was associated with a higher all-cause (17.2 vs 5.6 vs 3.0 %,
p
< 0.001) and cardiovascular mortality (10.9 vs 5.6 vs 2.5 %,
p
= 0.02) at 30 days compared to patients with major bleeding or no bleeding. Multivariate analysis identified transapical access (OR 2.6, 95 % CI 1.4–4.8;
p
= 0.002), glomerular filtration rate <30 ml/min (OR 2.3, 95 % CI 1.1–4.7,
p
= 0.031), and diabetes (OR 1.8, 95 % CI 1.001–3.2,
p
= 0.049) as independent predictors of life-threatening, peri-procedural bleeding. Life-threatening bleeding complications in patients undergoing TAVI are associated with increased mortality. Renal impairment, diabetes, and transapical approach were identified as independent risk factors for life-threatening bleeding events.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23143652</pmid><doi>10.1007/s11239-012-0842-3</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0929-5305 |
| ispartof | Journal of thrombosis and thrombolysis, 2013-05, Vol.35 (4), p.456-462 |
| issn | 0929-5305 1573-742X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1353043274 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Aged Aged, 80 and over Aortic Valve Stenosis - mortality Aortic Valve Stenosis - physiopathology Aortic Valve Stenosis - therapy Blood Loss, Surgical - mortality Blood Loss, Surgical - physiopathology Cardiac Catheterization - adverse effects Cardiac Catheterization - instrumentation Cardiac Catheterization - methods Cardiology Disease-Free Survival Female Follow-Up Studies Heart Valve Prosthesis Hematology Humans Incidence Male Medicine Medicine & Public Health Postoperative Hemorrhage - etiology Postoperative Hemorrhage - mortality Postoperative Hemorrhage - physiopathology Registries Retrospective Studies Risk Factors Survival Rate |
| title | Transcatheter aortic valve implantation and bleeding: incidence, predictors and prognosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T02%3A17%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Transcatheter%20aortic%20valve%20implantation%20and%20bleeding:%20incidence,%20predictors%20and%20prognosis&rft.jtitle=Journal%20of%20thrombosis%20and%20thrombolysis&rft.au=Pilgrim,%20Thomas&rft.date=2013-05-01&rft.volume=35&rft.issue=4&rft.spage=456&rft.epage=462&rft.pages=456-462&rft.issn=0929-5305&rft.eissn=1573-742X&rft_id=info:doi/10.1007/s11239-012-0842-3&rft_dat=%3Cproquest_cross%3E1353043274%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1353957794&rft_id=info:pmid/23143652&rfr_iscdi=true |