Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN‐TAVI registry. Issue 5 (1st October 2020)

• Record Type: Journal Article
• Authors: Nicolas, Johny; Claessen, Bimmer E.; Cao, Davide; Sartori, Samantha; Baber, Usman; Power, David; Chiarito, Mauro; Goel, Ridhima; Roumeliotis, Anastasios; Chandiramani, Rishi; Chen, Siyan; Chandrasekhar, Jaya; Tchetche, Didier; Petronio, Anna Sonia; Mehilli, Julinda; Lefèvre, Thierry; Presbitero, Patrizia; Capranzano, Piera; Iadanza, Alessandro; Sardella, Gennaro; Van Mieghem, Nicolas M; Meliga, Emanuele; Dumonteil, Nicolas; Fraccaro, Chiara; Trabattoni, Daniela; Mikhail, Ghada; Ferrer‐Gracia, Maria‐Cruz; Naber, Christoph; Sharma, Samin; Morice, Marie‐Claude; Dangas, George D.; Chieffo, Alaide; Mehran, Roxana;
• Is Part Of: Catheterization and cardiovascular interventions. Volume 97:Issue 5(2021)
• Page Start: E704
• Page End: E715
• Publication Date: 2020-10-01
• Subjects: anemia -- female -- TAVI -- TAVR; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29276
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: To assess the impact of anemia on clinical outcomes in female patients enrolled in the Women's InterNational transcatheter aortic valve implantation (WIN‐TAVI) registry. Background: Anemia is highly prevalent among females who constitute half of TAVI candidates, yet, its clinical significance remains poorly investigated. Methods: Patients were divided into three groups according to preprocedural hemoglobin (Hb) level: (1) no anemia (Hb ≥12 g/dl), (2) mild‐to‐moderate anemia (10 ≤ Hb <12 g/dl), and (3) severe anemia (Hb <10 g/dl). The primary outcome was the occurrence of Valve Academic Research Consortium (VARC)‐2 efficacy endpoint, a composite of mortality, stroke, myocardial infarction (MI), hospitalization for valve‐related symptoms or heart failure or valve‐related dysfunction at 1‐year follow‐up. Results: Hemoglobin level was available in 877 (86.1%) patients: 412 (47.0%) had no anemia, 363 (41.4%) had mild‐to‐moderate anemia, and 102 (11.6%) had severe anemia. The latter group had a higher prevalence of cardiovascular risk factors. Compared with patients without anemia, severe anemia was associated with a greater risk of VARC‐2 efficacy endpoint (adj HR 1.71, 95% CI: 1.02–2.87, p = .04), all‐cause death (adj HR 2.36, 95% CI: 1.31–4.26, p = .004) and a composite of death, MI or stroke (adj HR 1.88, 95% CI: 1.10–3.22, p = .02) at 1 year. Moreover, an increased risk of late mortality (adj HR 1.15, 95% CI: 1.02–1.30, p = .03) was observed with every 1 g/dl decrease in hemoglobin level. Conclusion: Severe anemia in females undergoing TAVI was independently associated with increased rates of VARC‐2 efficacy endpoint and mortality at 1 year.