Author + information
- Elsheikh Abdelrahim,
- Marvin Eng,
- Sarah Gorgis,
- Sagger Mawri,
- Dee Dee Wang,
- Adam Greenbaum,
- Meredith Mahan,
- Janet Wyman,
- Gaetano Paone and
- William O'Neill
Background: TAVR patients are often elderly with multiple comorbidities increasing their susceptibility to late bleeding. Post-TAVR anticoagulation is without data for guidance. To provide insight, the relationships between late bleeding, comorbidities and discharge medications were assesed.
Methods: Using a single center prospective database, we analyzed 500 consecutive TAVR patients. Bleeding events were classified according to VARC2 and BARC definitions. Clinical variables and discharge medications were compared in patients with and without bleeding. T-test and Chi-square were used to compare continuous and categorical variables respectively. Univariate logistic regression calculated odds ratios.
Results: Clinical variables, discharge medications and bleeding are described in Table 1. Mean time to bleeding events and follow up time were 14 ± 11.2 and 16.9 ± 12.7 months respectively. Thirty patients suffered VARC2/BARC3 bleeding (6%) within 1 year. Of 65 VARC2 major bleeds, most were gastrointestinal (n=40) in nature. Patients with prior bleeding [OR 2.17 CI 1.23-3.84] and dual-antiplatelet therapy (DAPT) [OR 1.91 CI 1.06-3.45] have increased odds for VARC major/life threatening bleeding. High HASBLED scores were not associated with bleeding[OR 1.13 CI 0.85-1.50].
Conclusions: Significant rates of late bleeding were observed. Prior history of bleeding and DAPT were predictors of late bleeding. This bears significant implications for prosthetic valve thromboprophylaxis.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: TAVR 3
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1243-181
- 2017 American College of Cardiology Foundation