TY  - BOOK
AU  - Badr, Salem
AU  - Barbash, Israel M
AU  - Ben-Dor, Itsik
AU  - Chen, Fang
AU  - Dvir, Danny
AU  - Fields, Jessica N
AU  - Loh, Joshua P
AU  - Minha, Sa'ar
AU  - Okubagzi, Petros
AU  - Pendyala, Lakshmana K
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Acquired thrombocytopenia after transcatheter aortic valve replacement: clinical correlates and association with outcomes
SN  - 0195-668X
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Thrombocytopenia/et [Etiology]
KW  - *Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Aged, 80 and over
KW  - Female
KW  - Humans
KW  - Length of Stay
KW  - Male
KW  - Platelet Count
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
KW  - Multicenter Study
N1  - Available online from MWHC library: 1996 - present (after 1 year), Available in print through MWHC library: 1999 - 2006
N2  - AIMS: This study aimed to evaluate incidence and correlates for low platelet count after transcatheter aortic valve replacement (TAVR) and to determine a possible association between acquired thrombocytopenia and clinical outcomes; CONCLUSIONS: Acquired thrombocytopenia was common after TAVR and was mostly resolved at patient discharge. The severity of thrombocytopenia after TAVR could be used as an excellent, easily obtainable, marker for worse short- and long-term outcomes after the procedure.Copyright Published on behalf of the European Society of Cardiology. All rights reserved. � The Author 2014. For permissions please email: journals.permissions@oup.com; METHODS AND RESULTS: Patients undergoing TAVR from two medical centres were included in the study. They were stratified according to nadir platelet count post procedure: no/mild thrombocytopenia, >100 x 10(9)/L; moderate, 50-99 x 10(9)/L; and severe, <50 x 10(9)/L. A total of 488 patients composed of the study population (age 84.7 +/- 7.5 years). At a median time of 2 days after TAVR, 176 patients (36.1%) developed significant thrombocytopenia: 149 (30.5%) moderate; 27 patients (5.5%) severe. Upon discharge, the vast majority of patients (90.2%) had no/mild thrombocytopenia. Nadir platelet count <50 x 10(9)/L was highly specific (96.3%), and a count <150 x 10(9)/L highly sensitive (91.2%), for predicting 30-day death (C-statistic 0.76). Patients with severe acquired thrombocytopenia had a significantly higher mortality rate at 1 year (66.7% for severe vs. 16.0% for no/mild vs. 20.1% for moderate; P < 0.001). In multivariate logistic regression, severe thrombocytopenia was independently associated with 1-year mortality (hazard ratio 3.44, CI: 1.02-11.6; P = 0.046)
UR  - http://dx.doi.org/10.1093/eurheartj/ehu082
ER  -