Recovery from anemia in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation--prevalence, predictors and clinical outcome.

Abstract

INTRODUCTION:

Preoperative anemia is common in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and has been linked to a poorer outcome--including a higher 1-year mortality. The aim of this study was to investigate the impact of successful TAVI on baseline anemia.

METHODS:

A total of 253 patients who survived at least 1 year following TAVI were included in this study. The prevalence, predictors and clinical outcome of hemoglobin (Hb)-recovery were assessed.

RESULTS:

The prevalence of baseline anemia was 49% (n = 124)--recovery from anemia occurred in 40% of the anemic patients (n = 49) at 1 year after TAVI with an increase in mean Hb-level of 1.35 g/dL from baseline. This increase was not related to an improvement in renal function. At multivariate analysis, a high peak gradient (OR 4.82, P = 0.003) was shown to be an independent predictor for Hb-recovery, while blood transfusion (OR 0.31, P = 0.038) and chronic kidney disease (CKD, OR 0.33, P = 0.043) were identified as negative predictors at, respectively, one and two years after TAVI. When compared to patients without baseline anemia, those anemic patients with Hb-recovery had a similar functional improvement (OR 0.98, P = 0.975), whereas those without Hb-recovery had a significantly lower likelihood of functional improvement with ≧2 NYHA classes (OR 0.49, P = 0.034) and a higher likelihood of re-hospitalization within the first year after TAVI (OR 1.91, P = 0.024).

CONCLUSION:

Recovery from anemia occurs in 40% of anemic patients at 1 year after TAVI--mainly in those with a high gradient and without CKD. Blood transfusion was found to have a transient adverse effect on this Hb-recovery. Finally, anemic patients without Hb-recovery experience less functional improvement and have a higher re-hospitalization rate within the first year after TAVI.

• Authors: Ole De Backer, Samer Arnous, Jacob Lønborg, Matthew Brooks, Luigi Biasco, Anders Jönsson, Olaf W Franzen, Lars Søndergaard
• Journal: PloS one (PLoS One) Vol. 9 Issue 12 Pg. e114038 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 25437191 (Publication Type: Journal Article)

Chemical References

• Hemoglobins

Topics

• Aged
• Aged, 80 and over
• Anemia (blood, complications, diagnosis, therapy)
• Aortic Valve Stenosis (blood, complications, diagnosis, surgery)
• Blood Transfusion
• Female
• Hemoglobins (analysis)
• Humans
• Male
• Prognosis
• Transcatheter Aortic Valve Replacement
• Treatment Outcome