Predictors of Thrombocytopenia after Self-Expandable Transcatheter Aortic Valve Replacement: A Single-Center Experience from China

Zhu, Qionghua; Liu, Xianbao; He, Wei; He, Yuxin; Tang, May; Sun, Ying-hao; Xü, Xinsheng; Shi, Keda; Kong, Huijia; Jiang, Jianwen; Chen, Liang-Wei; Chen, Jie; Hu, Po; Xu, Qian; Wang, Jianan

doi:10.1159/000484627

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…In the last few years, several TAVI-rTP investigations were conducted, mostly on Core-valves and some on Sapien valves [6][7][8][9][10][11][12] and only one study compared between the two types of expandable systems. 13,14 These studies include heterogeneous TAVI indications and different technologies, comparable to our study.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, TAVI has evolved to be simpler and safer 4‐5 . TAVI related thrombocytopenia (TAVI‐rTP) is a common periprocedural finding 6‐8 . A decrease in platelet count appears in nearly 90% of the treated patients 9 and the severity of this phenomenon has been associated with worse clinical outcomes 10‐14 .…”

Section: Introductionmentioning

confidence: 99%

“…[4][5] TAVI related thrombocytopenia (TAVI-rTP) is a common periprocedural finding. [6][7][8] A decrease in platelet count appears in nearly 90% of the treated patients 9 and the severity of this phenomenon has been associated with worse clinical outcomes. [10][11][12][13][14] The current explanation for the TAVI-rTP mechanism implies platelet activation and a systemic inflammatory response.…”

Section: Introductionmentioning

confidence: 99%

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Contemporary transcatheter aortic valve implantation related thrombocytopenia

Khadija

Ayyad

Haberman

et al. 2020

Cathet Cardio Intervent

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Background: Transcatheter aortic valve implantation related thrombocytopenia (TAVI-rTP) is an inevitable phenomenon. However, no study has been performed on TAVI-rTP in the current setting of extended clinical indications combined with technology improvements.Methods: Patients with severe symptomatic aortic stenosis who underwent transfemoral TAVI, from January 2016 to December 2019 were enrolled.Results: Two-hundred and one consecutive patients (mean age 81.1 ± 7.1 years, 96 men) enrolled. Platelet count was recorded before and after aortic valve implantation. Dropped platelet count (DPC) occurred in all but 11 patients who were included.Two groups were created: DPC <30 and DPC ≥30%. DPC was compared with inhospital major adverse cardiovascular events. The mean DPC was 26 ± 14%. We found that 67 patients (33.3%) had DPC of more or equal to 30%. In the univariable analysis, the time of the procedure (94.4 ± 32.7 vs 79.4 ± 21.9, p = .002), the amount of the contrast used (125.4 ± 55.4 vs 108.4 ± 44.1, p = .02) and the residual AV gradient (13.3 ± 7.2 vs 14.7, p = .05) were related to a DCP ≥30%. A DPC ≥30% was associated with increased risk of life-threatening/major bleeding (11.9% vs 1.5%, p = .001), major vascular complications (16.4% vs 5.2% p = .009) and death (3.0% vs 0%, p = .044) at 30 days. After multivariable analysis, the factors associated with a higher DPC were time and contrast. Conclusion:Contemporary TAVI-rTP in this cohort of patients continues to be a common phenomenon but severe thrombocytopenia is less frequent. Patients developing a DPC ≥30% are associated with poor outcomes at 30 days.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contemporary transcatheter aortic valve implantation related thrombocytopenia

Khadija

Ayyad

Haberman

et al. 2020

Cathet Cardio Intervent

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“…A large body of evidence demonstrated that thrombocytopenia is inevitable after transcatheter aortic valve replacement (TAVR) (1)(2)(3)(4), and that severe thrombocytopenia are significantly associated with worse clinical outcomes (1)(2)(3)(5)(6)(7)(8). With the development of TAVR technology, TAVR is an established treatment for selected severe symptomatic aortic stenosis (AS), and its safety and efficacy in patients with aortic regurgitation (AR) has also been explored (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Predictive model for severe thrombocytopenia after transfemoral transcatheter aortic valve replacement

Wang

et al. 2023

Front. Cardiovasc. Med.

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The aim of this study was to develop a predictive model for severe thrombocytopenia after transfemoral transcatheter aortic valve replacement (TAVR). A total of 155 patients treated with TAVR at our center were retrospectively enrolled in this study. The incidence of severe thrombocytopenia after TAVR was 25.16%, and most patients suffered from severe thrombocytopenia on 4 days after procedure. Multivariate regression analysis showed that weight <60 kg, New York Heart Association Functional Classification (NYHAFC IV), major vascular complications, and lower first post-procedural platelet count were independent risk factors for severe thrombocytopenia after TAVR. The c-statistic for the area under the curve was 0.758, the sensitivity was 0.744, the specificity was 0.784, and the negative predictive value of the model was 91.38%. The overall predictive value was 76.77%. The predictive model developed from this cohort data could effectively identify patients at high risk of severe thrombocytopenia after TAVR, and might be applicable to patients with aortic regurgitation (AR) and severe thrombocytopenia with different definitions.

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“…Transcatheter aortic valve implantation (TAVI) related thrombocytopenia (TAVI-rTP) is a common periprocedural finding [1][2][3]. Flaherty et al coined the concept that TAVI-rTP may be a "universal and virtually inevitable" phenomenon [4].…”

Section: Introductionmentioning

confidence: 99%

Trends in Transfemoral Aortic Valve Implantation Related Thrombocytopenia

Khadija

Gandelman

Ayyad

et al. 2022

JCM

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Background: TAVI related thrombocytopenia (TAVI-rTP) is still very common. The aim of this study was to compare the incidence, characteristics and impact of reduced platelet counts (RPC) after TAVI between an earlier and contemporary period. Methods: the patients enrolled were those experiencing severe symptomatic aortic stenosis who underwent TAVI between January 2010 and December 2019. The exclusion criteria were no available blood tests and periprocedural death. Results: 334 patients (mean age 81.9 ± 6.7 years) were enrolled. For the earlier period, the mean RPC was 33 ± 15%, and in the contemporary period (2016–2019) it was 26 ± 14%. In the early group, we found that 62% of the patients had decreased platelet counts of more or equal to 30% in comparison to 33% in the contemporary period. The time of the procedure and the amount of the contrast that had been used in the later period were associated with significant RPCs (p value = 0.002 and 0.028, respectively). An RPC of 30% or more was associated with the increased risks of life-threatening bleeding, vascular complications and death within 30 days. Conclusion: contemporary TAVI-rTP continued to be a common phenomenon in our cohort. However, severe thrombocytopenia was significantly less frequent. An RPC of 30% or more is associated with a poor 30-day outcome.

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Predictors of Thrombocytopenia after Self-Expandable Transcatheter Aortic Valve Replacement: A Single-Center Experience from China

Cited by 7 publications

References 24 publications

Contemporary transcatheter aortic valve implantation related thrombocytopenia

Contemporary transcatheter aortic valve implantation related thrombocytopenia

Predictive model for severe thrombocytopenia after transfemoral transcatheter aortic valve replacement

Trends in Transfemoral Aortic Valve Implantation Related Thrombocytopenia

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