E-40 | Aortic Stenosis Associated Thrombocytopenia: A New Prognostic Marker? A Nationwide Study

Abstract

Aortic stenosis (AS) has been reported to be associated with hemolytic anemia as a result of shearing forces on red blood cells passing through the stenotic valve area. Recent literature also suggests platelets play a key role in the calcific degeneration of the aortic valve through platelet deposition and stenosis. Our study aims to determine the prevalence of thrombocytopenia (TCP) in patients diagnosed with AS and the impact of TCP on outcomes including mortality in these patients. De-identified patient data from the National Inpatient Sample (NIS) from 2016-2019 were queried. Inclusion criteria included a diagnosis of AS and TCP. Data was analyzed using SPSS software, a p value <0.001 was considered statistically significant, and samples were standardized for comparison using predicted probabilities. Of the 30m+ patients in the NIS, there were 300,728 patients diagnosed with AS from 2016 to 2019. During hospitalization, 7,013 (2.33%) patients died, 15,237 (5.07%) were concurrently diagnosed with TCP, and 152,733 (50.79%) were females. There was a statistically significant increased likelihood of being diagnosed with TCP in patients with AS (p<0.001). Furthermore, those patients diagnosed with TCP and concomitant AS were also at an increased risk of mortality as compared to AS patients without TCP (p<0.001). Patients diagnosed with AS were more likely to also be diagnosed with TCP. Moreover, AS patients also diagnosed with concurrent TCP were at an increased risk of death, possibly attributable to their increased bleeding risk and complications including from post procedural access sites. This demonstrates TCP may serve as a potential prognostic indicator when assessing the peri procedural risk profile for a TAVR and the likelihood of mortality including bleeding complications. Patients with AS should be judiciously evaluated for use of transcatheter aortic valve replacement (TAVR) intervention when concomitantly diagnosed with TCP.