التفاصيل البيبلوغرافية
| العنوان: |
Primary hemostatic disorders and late major bleeding after transcatheter aortic valve replacement |
| المؤلفون: |
Kibler, Marion, Marchandot, Benjamin, Messas, Nathan, Labreuche, Julien, Vincent, Flavien, Grunebaum, Lelia, Hoang, Viet Anh, Reydel, Antje, Crimizade, Ulun, Kindo, Michel, Hoang, Minh Tam, Zeyons, Floriane, Trinh, Annie, Petit-Eisenmann, Helene, De Poli, Fabien, Leddet, Pierre, Duhamel, Alain, Jesel, Laurence, Ohana, Mickael, Susen, Sophie, Ohlmann, Patrick, Van Belle, Eric, Morel, Olivier |
| المساهمون: |
CHU Lille, Inserm, Institut Pasteur de Lille, Université de Lille, Santé publique : épidémiologie et qualité des soins - EA 2694, Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (EGID) - U1011, Université de Strasbourg UNISTRA, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 METRICS, Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 RNMCD, Centre Hospitalier Universitaire Strasbourg CHU Strasbourg, Centre hospitalier de Haguenau |
| سنة النشر: |
2024 |
| المجموعة: |
LillOA (Lille Open Archive - Université de Lille) |
| مصطلحات موضوعية: |
transcatheter aortic valve replacement, von Willebrand syndrome, aortic stenosis, late major/life-threatening bleeding, paravalvular aortic regurgitation |
| الوصف: |
Periprocedural and late (>30 days) bleedings represent major complications after transcatheter aortic valve replacement and have been identified as potential areas for improved patient care. The authors sought to evaluate the impact of ongoing primary hemostasis disorders on late major/life-threatening bleeding complications (MLBCs). Bleedings were assessed according to the VARC-2 (Valve Academic Research Consortium-2) criteria. Closure time of adenosine diphosphate (CT-ADP), a surrogate marker of high molecular weight von Willebrand multimers proteolysis was assessed 24 h after the procedure. Ongoing primary hemostasis disorder was defined by a CT-ADP >180 s. Among 372 patients who survived at 30 days, MLBCs occurred in 42 patients (11.3%) at a median follow-up of 383 days (interquartile range: 188 to 574 days). MLBCs were mainly of gastrointestinal origin (42.8%) and were associated with increased overall mortality (hazard ratio [HR]: 5.66; 95% confidence interval [CI]: 3.10 to 10.31; p < 0.001) and cardiac mortality (HR: 11.62; 95% CI: 4.59 to 29.37; p < 0.001). A 2.5-fold elevation of MLBCs could be evidenced in patients with a CT-ADP > 180 s (27.4% vs. 11.5%; p < 0.001). Multivariate regression analysis identified paravalvular leak (PVL) (HR: 6.31; 95% CI: 3.43 to 11.60; p < 0.0001) and CT-ADP > 180 s (HR: 3.08; 95% CI: 1.62 to 5.81; p = 0.0005) as predictor of MLBCs. MLBCs after transcatheter aortic valve replacement are frequent and associated with an increased morbidity and mortality. PVL and CT-ADP >180 s were identified as strong predictors for MLBCs. These findings strongly suggest that persistent HMW defects contribute to enhanced bleeding risk in patients with residual PVL. ; 72 |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| Relation: |
Journal of the American College of Cardiology; J. Am. Coll. Cardiol.; http://hdl.handle.net/20.500.12210/17366 |
| الاتاحة: |
https://hdl.handle.net/20.500.12210/17366 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| رقم الانضمام: |
edsbas.AA2CFE23 |
| قاعدة البيانات: |
BASE |