Why the study?
TAVI-related thrombocytopenia remains common, but changes in the incidence, characteristics, and impact of reduced platelet counts between earlier and contemporary periods were unclear.
Does the incidence and impact of TAVI-related thrombocytopenia differ between earlier and contemporary periods in patients undergoing TAVI?
Does the incidence and impact of TAVI-related thrombocytopenia differ between earlier and contemporary periods in patients undergoing TAVI?
While TAVI-related thrombocytopenia remains common, severe thrombocytopenia has become less frequent in contemporary practice, though an RPC ≥30% remains associated with poor 30-day outcomes.
Reduced platelet count ≥30% remains linked to early TAVI risks; leaves open whether monitoring or interventions alter outcomes in contemporary practice.
Background: TAVI related thrombocytopenia (TAVI-rTP) is still very common. The aim of this study was to compare the incidence, characteristics and impact of reduced platelet counts (RPC) after TAVI between an earlier and contemporary period. Methods: the patients enrolled were those experiencing severe symptomatic aortic stenosis who underwent TAVI between January 2010 and December 2019. The exclusion criteria were no available blood tests and periprocedural death. Results: 334 patients (mean age 81.9 ± 6.7 years) were enrolled. For the earlier period, the mean RPC was 33 ± 15%, and in the contemporary period (2016–2019) it was 26 ± 14%. In the early group, we found that 62% of the patients had decreased platelet counts of more or equal to 30% in comparison to 33% in the contemporary period. The time of the procedure and the amount of the contrast that had been used in the later period were associated with significant RPCs (p value = 0.002 and 0.028, respectively). An RPC of 30% or more was associated with the increased risks of life-threatening bleeding, vascular complications and death within 30 days. Conclusion: contemporary TAVI-rTP continued to be a common phenomenon in our cohort. However, severe thrombocytopenia was significantly less frequent. An RPC of 30% or more is associated with a poor 30-day outcome.
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Khadija et al. (2022) studied this question.
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