Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry

Johny Nicolas; Bimmer E. Claessen; Davide Cao; Samantha Sartori; Usman Baber; David Power; Mauro Chiarito; Ridhima Goel; Anastasios Roumeliotis; Rishi Chandiramani; Siyan Chen; Jaya Chandrasekhar; Didier Tchetche; Anna Sonia Petronio; Julinda Mehilli; Thierry Lefèvre; Patrizia Presbitero; Piera Capranzano; Alessandro Iadanza; Gennaro Sardella; Nicolas M. Van Mieghem; Emanuele Meliga; Nicolas Dumonteil; Chiara Fraccaro; Daniela Trabattoni; Ghada Mikhail; Maria Cruz Ferrer-Gracia; Christoph Naber; Samin Sharma; Marie Claude Morice; George D. Dangas; Alaide Chieffo; Roxana Mehran

doi:10.1002/ccd.29276

Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry

Johny Nicolas
, Bimmer E. Claessen
, Davide Cao
, Samantha Sartori
, Usman Baber
, David Power
, Mauro Chiarito
, Ridhima Goel
, Anastasios Roumeliotis
, Rishi Chandiramani
, Siyan Chen
, Jaya Chandrasekhar
, Didier Tchetche
, Anna Sonia Petronio
, Julinda Mehilli
, Thierry Lefèvre
, Patrizia Presbitero
, Piera Capranzano
, Alessandro Iadanza
, Gennaro Sardella

Nicolas M. Van Mieghem, Emanuele Meliga, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Maria Cruz Ferrer-Gracia, Christoph Naber, Samin Sharma, Marie Claude Morice, George D. Dangas, Alaide Chieffo, Roxana Mehran^*

^*Corresponding author for this work

Cardiology

Icahn School of Medicine at Mount Sinai
IRCCS Istituto Clinico Humanitas - Rozzano (Milano)
Clinique Pasteur Toulouse
University of Pisa
Klinikum der Universität München
Institut Hospitalier Jacques Cartier
University of Catania
Azienda Ospedaliera Universitaria Senese
University of Rome La Sapienza
Université Paul Sabatier Toulouse III
University of Padua
IRCCS Centro Cardiologico S.P.A. Fondazione Monzino - Milano
Hammersmith Hospital
University of Zaragoza
Elisabeth-Krankenhaus Essen
Vita-Salute San Raffaele University

Research output: Contribution to journal › Article › Academic › peer-review

12 Citations (Scopus)

Abstract

Objectives: To assess the impact of anemia on clinical outcomes in female patients enrolled in the Women's InterNational transcatheter aortic valve implantation (WIN-TAVI) registry. Background: Anemia is highly prevalent among females who constitute half of TAVI candidates, yet, its clinical significance remains poorly investigated. Methods: Patients were divided into three groups according to preprocedural hemoglobin (Hb) level: (1) no anemia (Hb ≥12 g/dl), (2) mild-to-moderate anemia (10 ≤ Hb <12 g/dl), and (3) severe anemia (Hb <10 g/dl). The primary outcome was the occurrence of Valve Academic Research Consortium (VARC)-2 efficacy endpoint, a composite of mortality, stroke, myocardial infarction (MI), hospitalization for valve-related symptoms or heart failure or valve-related dysfunction at 1-year follow-up. Results: Hemoglobin level was available in 877 (86.1%) patients: 412 (47.0%) had no anemia, 363 (41.4%) had mild-to-moderate anemia, and 102 (11.6%) had severe anemia. The latter group had a higher prevalence of cardiovascular risk factors. Compared with patients without anemia, severe anemia was associated with a greater risk of VARC-2 efficacy endpoint (_adjHR 1.71, 95% CI: 1.02–2.87, p =.04), all-cause death (_adjHR 2.36, 95% CI: 1.31–4.26, p =.004) and a composite of death, MI or stroke (_adjHR 1.88, 95% CI: 1.10–3.22, p =.02) at 1 year. Moreover, an increased risk of late mortality (_adjHR 1.15, 95% CI: 1.02–1.30, p =.03) was observed with every 1 g/dl decrease in hemoglobin level. Conclusion: Severe anemia in females undergoing TAVI was independently associated with increased rates of VARC-2 efficacy endpoint and mortality at 1 year.

Original language	English
Pages (from-to)	E704-E715
Journal	Catheterization and Cardiovascular Interventions
Volume	97
Issue number	5
DOIs	https://doi.org/10.1002/ccd.29276
Publication status	Published - 1 Apr 2021

Bibliographical note

Access to Document

10.1002/ccd.29276

Cite this

Nicolas, J., Claessen, B. E., Cao, D., Sartori, S., Baber, U., Power, D., Chiarito, M., Goel, R., Roumeliotis, A., Chandiramani, R., Chen, S., Chandrasekhar, J., Tchetche, D., Petronio, A. S., Mehilli, J., Lefèvre, T., Presbitero, P., Capranzano, P., Iadanza, A., ... Mehran, R. (2021). Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry. Catheterization and Cardiovascular Interventions, 97(5), E704-E715. https://doi.org/10.1002/ccd.29276

@article{d9efe207d8684376a55b934eb9648d22,

title = "Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry",

abstract = "Objectives: To assess the impact of anemia on clinical outcomes in female patients enrolled in the Women's InterNational transcatheter aortic valve implantation (WIN-TAVI) registry. Background: Anemia is highly prevalent among females who constitute half of TAVI candidates, yet, its clinical significance remains poorly investigated. Methods: Patients were divided into three groups according to preprocedural hemoglobin (Hb) level: (1) no anemia (Hb ≥12 g/dl), (2) mild-to-moderate anemia (10 ≤ Hb <12 g/dl), and (3) severe anemia (Hb <10 g/dl). The primary outcome was the occurrence of Valve Academic Research Consortium (VARC)-2 efficacy endpoint, a composite of mortality, stroke, myocardial infarction (MI), hospitalization for valve-related symptoms or heart failure or valve-related dysfunction at 1-year follow-up. Results: Hemoglobin level was available in 877 (86.1\%) patients: 412 (47.0\%) had no anemia, 363 (41.4\%) had mild-to-moderate anemia, and 102 (11.6\%) had severe anemia. The latter group had a higher prevalence of cardiovascular risk factors. Compared with patients without anemia, severe anemia was associated with a greater risk of VARC-2 efficacy endpoint (adjHR 1.71, 95\% CI: 1.02{\textendash}2.87, p =.04), all-cause death (adjHR 2.36, 95\% CI: 1.31{\textendash}4.26, p =.004) and a composite of death, MI or stroke (adjHR 1.88, 95\% CI: 1.10{\textendash}3.22, p =.02) at 1 year. Moreover, an increased risk of late mortality (adjHR 1.15, 95\% CI: 1.02{\textendash}1.30, p =.03) was observed with every 1 g/dl decrease in hemoglobin level. Conclusion: Severe anemia in females undergoing TAVI was independently associated with increased rates of VARC-2 efficacy endpoint and mortality at 1 year.",

author = "Johny Nicolas and Claessen, \{Bimmer E.\} and Davide Cao and Samantha Sartori and Usman Baber and David Power and Mauro Chiarito and Ridhima Goel and Anastasios Roumeliotis and Rishi Chandiramani and Siyan Chen and Jaya Chandrasekhar and Didier Tchetche and Petronio, \{Anna Sonia\} and Julinda Mehilli and Thierry Lef{\`e}vre and Patrizia Presbitero and Piera Capranzano and Alessandro Iadanza and Gennaro Sardella and \{Van Mieghem\}, \{Nicolas M.\} and Emanuele Meliga and Nicolas Dumonteil and Chiara Fraccaro and Daniela Trabattoni and Ghada Mikhail and Ferrer-Gracia, \{Maria Cruz\} and Christoph Naber and Samin Sharma and Morice, \{Marie Claude\} and Dangas, \{George D.\} and Alaide Chieffo and Roxana Mehran",

note = "Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals LLC.",

year = "2021",

month = apr,

day = "1",

doi = "10.1002/ccd.29276",

language = "English",

volume = "97",

pages = "E704--E715",

number = "5",

}

Nicolas, J, Claessen, BE, Cao, D, Sartori, S, Baber, U, Power, D, Chiarito, M, Goel, R, Roumeliotis, A, Chandiramani, R, Chen, S, Chandrasekhar, J, Tchetche, D, Petronio, AS, Mehilli, J, Lefèvre, T, Presbitero, P, Capranzano, P, Iadanza, A, Sardella, G, Van Mieghem, NM, Meliga, E, Dumonteil, N, Fraccaro, C, Trabattoni, D, Mikhail, G, Ferrer-Gracia, MC, Naber, C, Sharma, S, Morice, MC, Dangas, GD, Chieffo, A & Mehran, R 2021, 'Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry', Catheterization and Cardiovascular Interventions, vol. 97, no. 5, pp. E704-E715. https://doi.org/10.1002/ccd.29276

TY - JOUR

T1 - Preprocedural anemia in females undergoing transcatheter aortic valve implantation

T2 - Insights from the WIN-TAVI registry

AU - Nicolas, Johny

AU - Claessen, Bimmer E.

AU - Cao, Davide

AU - Sartori, Samantha

AU - Baber, Usman

AU - Power, David

AU - Chiarito, Mauro

AU - Goel, Ridhima

AU - Roumeliotis, Anastasios

AU - Chandiramani, Rishi

AU - Chen, Siyan

AU - Chandrasekhar, Jaya

AU - Tchetche, Didier

AU - Petronio, Anna Sonia

AU - Mehilli, Julinda

AU - Lefèvre, Thierry

AU - Presbitero, Patrizia

AU - Capranzano, Piera

AU - Iadanza, Alessandro

AU - Sardella, Gennaro

AU - Van Mieghem, Nicolas M.

AU - Meliga, Emanuele

AU - Dumonteil, Nicolas

AU - Fraccaro, Chiara

AU - Trabattoni, Daniela

AU - Mikhail, Ghada

AU - Ferrer-Gracia, Maria Cruz

AU - Naber, Christoph

AU - Sharma, Samin

AU - Morice, Marie Claude

AU - Dangas, George D.

AU - Chieffo, Alaide

AU - Mehran, Roxana

PY - 2021/4/1

Y1 - 2021/4/1

N2 - Objectives: To assess the impact of anemia on clinical outcomes in female patients enrolled in the Women's InterNational transcatheter aortic valve implantation (WIN-TAVI) registry. Background: Anemia is highly prevalent among females who constitute half of TAVI candidates, yet, its clinical significance remains poorly investigated. Methods: Patients were divided into three groups according to preprocedural hemoglobin (Hb) level: (1) no anemia (Hb ≥12 g/dl), (2) mild-to-moderate anemia (10 ≤ Hb <12 g/dl), and (3) severe anemia (Hb <10 g/dl). The primary outcome was the occurrence of Valve Academic Research Consortium (VARC)-2 efficacy endpoint, a composite of mortality, stroke, myocardial infarction (MI), hospitalization for valve-related symptoms or heart failure or valve-related dysfunction at 1-year follow-up. Results: Hemoglobin level was available in 877 (86.1%) patients: 412 (47.0%) had no anemia, 363 (41.4%) had mild-to-moderate anemia, and 102 (11.6%) had severe anemia. The latter group had a higher prevalence of cardiovascular risk factors. Compared with patients without anemia, severe anemia was associated with a greater risk of VARC-2 efficacy endpoint (adjHR 1.71, 95% CI: 1.02–2.87, p =.04), all-cause death (adjHR 2.36, 95% CI: 1.31–4.26, p =.004) and a composite of death, MI or stroke (adjHR 1.88, 95% CI: 1.10–3.22, p =.02) at 1 year. Moreover, an increased risk of late mortality (adjHR 1.15, 95% CI: 1.02–1.30, p =.03) was observed with every 1 g/dl decrease in hemoglobin level. Conclusion: Severe anemia in females undergoing TAVI was independently associated with increased rates of VARC-2 efficacy endpoint and mortality at 1 year.

AB - Objectives: To assess the impact of anemia on clinical outcomes in female patients enrolled in the Women's InterNational transcatheter aortic valve implantation (WIN-TAVI) registry. Background: Anemia is highly prevalent among females who constitute half of TAVI candidates, yet, its clinical significance remains poorly investigated. Methods: Patients were divided into three groups according to preprocedural hemoglobin (Hb) level: (1) no anemia (Hb ≥12 g/dl), (2) mild-to-moderate anemia (10 ≤ Hb <12 g/dl), and (3) severe anemia (Hb <10 g/dl). The primary outcome was the occurrence of Valve Academic Research Consortium (VARC)-2 efficacy endpoint, a composite of mortality, stroke, myocardial infarction (MI), hospitalization for valve-related symptoms or heart failure or valve-related dysfunction at 1-year follow-up. Results: Hemoglobin level was available in 877 (86.1%) patients: 412 (47.0%) had no anemia, 363 (41.4%) had mild-to-moderate anemia, and 102 (11.6%) had severe anemia. The latter group had a higher prevalence of cardiovascular risk factors. Compared with patients without anemia, severe anemia was associated with a greater risk of VARC-2 efficacy endpoint (adjHR 1.71, 95% CI: 1.02–2.87, p =.04), all-cause death (adjHR 2.36, 95% CI: 1.31–4.26, p =.004) and a composite of death, MI or stroke (adjHR 1.88, 95% CI: 1.10–3.22, p =.02) at 1 year. Moreover, an increased risk of late mortality (adjHR 1.15, 95% CI: 1.02–1.30, p =.03) was observed with every 1 g/dl decrease in hemoglobin level. Conclusion: Severe anemia in females undergoing TAVI was independently associated with increased rates of VARC-2 efficacy endpoint and mortality at 1 year.

UR - https://www.scopus.com/pages/publications/85091773458

U2 - 10.1002/ccd.29276

DO - 10.1002/ccd.29276

M3 - Article

C2 - 33002302

AN - SCOPUS:85091773458

SN - 1522-1946

VL - 97

SP - E704-E715

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

IS - 5

ER -

Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry

Abstract

Bibliographical note

Access to Document

Other files and links

Fingerprint

Cite this