Abstract
Background. Vascular and bleeding complications remain important complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI). Platelets play an important role in bleeding events. Mean platelet volume (MPV) is an indicator of platelet activation. The objective of this study was to assess whether low MPV is an indicator of major vascular and bleeding complications following TF-TAVI. Methods. A retrospective cohort study of 330 subjects undergoing TF-TAVI implantation was performed. The primary study endpoint was the occurrence of combined safety endpoint (CSEP); secondary endpoints included major vascular complications and life-threatening bleeding. Endpoints were defined according to Valve Academic Research Consortium 2. Results. The CSEP at 30 days was reached in 30.9%; major vascular complications were observed in 14.9% while life-threatening bleeding occurred in 20.6%. Logistic Euroscore and MPV were independent predictors of CSEP. Predictors of vascular complications were female sex, previous myocardial infarction, red blood cell distribution width (RDW), and MPV while predictors of life-threatening bleeding were peripheral arterial disease, RDW, and MPV. Conclusion. A low baseline MPV was shown for the first time to be a significant predictor of CSEP, major vascular complications, and life-threatening bleeding following TF-TAVI.
Highlights
Transcatheter aortic valve implantation (TAVI) has emerged as a valid treatment option for patients with symptomatic severe aortic stenosis and at high risk for conventional surgical aortic valve replacement
The objective of this study was to assess whether low Mean platelet volume (MPV) is an indicator of combined safety endpoint and major vascular and bleeding complications following percutaneous transfemoral aortic valve implantation (TF-TAVI)
Thirty-nine per cent of the patients suffered from coronary artery disease (CAD), 23% had peripheral arterial disease (PAD), 29% had diabetes mellitus, 30.5% had chronic renal insufficiency, and 30.7% suffered from chronic obstructive pulmonary disease (COPD) while 15% exhibited impaired left ventricular (LV) function
Summary
Transcatheter aortic valve implantation (TAVI) has emerged as a valid treatment option for patients with symptomatic severe aortic stenosis and at high risk for conventional surgical aortic valve replacement. Vascular and bleeding complications remain important complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI). The objective of this study was to assess whether low MPV is an indicator of major vascular and bleeding complications following TF-TAVI. The primary study endpoint was the occurrence of combined safety endpoint (CSEP); secondary endpoints included major vascular complications and life-threatening bleeding. The CSEP at 30 days was reached in 30.9%; major vascular complications were observed in 14.9% while life-threatening bleeding occurred in 20.6%. A low baseline MPV was shown for the first time to be a significant predictor of CSEP, major vascular complications, and life-threatening bleeding following TF-TAVI
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