MedStar Authors catalog › Details for: Impact of blood transfusions on short- and long-term mortality in patients who underwent transcatheter aortic valve implantation.
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Impact of blood transfusions on short- and long-term mortality in patients who underwent transcatheter aortic valve implantation.

by Escarcega, Ricardo O; Lipinski, Michael J; Magalhaes, Marco A; Baker, Nevin C; Minha, Sa'ar; Okubagzi, Petros; Torguson, Rebecca; Chen, Fang; Ben-Dor, Itsik; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron.
Citation: American Journal of Cardiology. 115(1):93-9, 2015 Jan 1..Journal: The American journal of cardiology.ISSN: 0002-9149.Full author list: Escarcega RO; Lipinski MJ; Magalhaes MA; Baker NC; Minha S; Okubagzi PG; Torguson R; Chen F; Ben-Dor I; Satler LF; Pichard AD; Waksman R.UI/PMID: 25491008.Subject(s): Aged, 80 and over | Anemia/co [Complications] | *Anemia/mo [Mortality] | *Anemia/th [Therapy] | Aortic Valve Stenosis/co [Complications] | *Aortic Valve Stenosis/mo [Mortality] | *Aortic Valve Stenosis/su [Surgery] | *Blood Transfusion | District of Columbia/ep [Epidemiology] | Female | Follow-Up Studies | Humans | Male | *Preoperative Care/mt [Methods] | Prognosis | Retrospective Studies | Survival Rate/td [Trends] | Time Factors | *Transcatheter Aortic Valve Replacement/mt [Methods]Institution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Online resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: Am J Cardiol. 115(1):93-9, 2015 Jan 1.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Baseline anemia is associated with transfusions and increased risk of mortality in patients who underwent cardiac surgery and percutaneous coronary intervention. The impact of blood transfusions in anemic patients who underwent transcatheter aortic valve implantation (TAVI) remains unclear. All patients who underwent transfemoral TAVI at our institution were retrospectively included. We determined the effect of blood transfusions on short- and long-term mortality and its interaction with baseline hemoglobin levels and bleeding complications. Additionally, we evaluated baseline hemoglobin effect on mortality. A total of 332 patients were included. All patients (99%) except 2 (1%) met the definition for anemia. Of the 332 patients, 124 (37%) received a blood transfusion and 208 (63%) did not. Blood transfusions were associated with increased in-hospital (p <0.001), 30-day (p <0.001), and 1-year (28% vs 13%, p = 0.001) mortality; however, after a landmark analysis, the effect of blood transfusion on mortality was only seen within 30 days of the procedure (p = 0.001). The increased risk of mortality associated with blood transfusion was present after multivariate adjustment at 30 days (hazard ratio 3.59 [1.04 to 12.4]; p = 0.04). Major vascular complications were a correlate for short- and long-term death. In contrast, baseline hemoglobin level and bleeding complications were not independently associated with mortality. The p value for interaction was not significant between transfusion and hemoglobin level and for transfusion and bleeding complication and transfusion and major vascular complication. In conclusion, the presence of anemia in patients who underwent TAVI does not affect mortality. Transfusion is a correlate of all-cause mortality in this patient population and should be used with caution. Copyright � 2015 Elsevier Inc. All rights reserved.

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