Key result
A history of anemia was the strongest independent predictor of in-hospital serious bleeding according to the GUSTO scale (OR 6.75) in patients undergoing transcatheter aortic valve implantation.
Observational (n=56)
No
Odds Ratio: 6.75 (95% CI 1.946–23.416)
p-value: p=0.0026
History of anemia is a strong predictor of serious bleeding after TAVI, and the GUSTO scale better predicts the need for blood transfusions compared to the TIMI scale.
Anemia history signals high bleeding risk in TAVI; leaves optimal antithrombotic regimens open for prospective confirmation.
BACKGROUND: The risk of bleedings in transcatheter aortic valve implantation (TAVI) patients increases due to age and concomitant diseases. The aim of the study was to assess the risk of bleedings, their influence on early prognosis of TAVI patients and utility of the TIMI and GUSTO scales in the evaluation of bleeding and in prediction of blood transfusion. METHODS: This was a single center study of in-hospital bleedings in 56 consecutive TAVI patients. Bleedings were classified according to the GUSTO and TIMI scales. HASBLED's scale risk factors, diabetes mellitus, female sex, the route of bioprosthesis implantation and inhospital antithrombotic treatment were analyzed. Statistical analysis consisted of c2, Fisher's exact, Wilcoxon tests and logistic regression analysis. RESULTS: Serious bleedings occurred in 35 (62.5%) patients. There was no significant correlation with HASBLED score. History of anemia was a significant predictor of bleeding in GUSTO (p = 0.0013) and TIMI (p = 0.048) scales. No bleedings in patients receiving vitamin K antagonists (VKA) pre- and VKA plus clopidogrel post intervention were observed. Patients with bleedings according to the GUSTO scale more often required blood tranfusion than in TIMI scale (p = 0.03). CONCLUSIONS: History of anemia is the strongest predictor of serious bleedings. VKA before and VKA with clopidogrel after TAVI are safer than dual antiplatelet or triple therapy. The TIMI and GUSTO scales can adequately classify bleeding after TAVI, however the GUSTO better predicts transfusions.
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Stępińska et al. (2013) conducted an observational in Severe, symptomatic aortic valve stenosis (n=56). History of anemia vs. No history of anemia was evaluated on In-hospital serious bleeding (GUSTO scale) (OR 6.750, 95% CI 1.946-23.416, p=0.0026). A history of anemia was the strongest independent predictor of in-hospital serious bleeding according to the GUSTO scale (OR 6.75) in patients undergoing transcatheter aortic valve implantation.
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