Combination of Primary Hemostatic Disorders and Atrial Fibrillation Increases Bleeding Events Following Transcatheter Aortic Valve Replacement

Figures

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  Fig. 1.. Study design. AF, atrial fibrillation; CT-ADP, closure time adenosine diphosphate; TAVR, transcatheter aortic valve replacement.

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  Fig. 2.. Cumulative incidence of ( A ) all-cause mortality, ( B ) heart failure hospitalization, ( C ) MACCE, and ( D ) major/life-threatening bleeding complications were significantly higher in AF patients than in non-AF patients. AF, atrial fibrillation; MACCE, major adverse cardiac and cerebrovascular events.

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  Fig. 3.. Cumulative event rates of all-cause mortality ( A ), heart failure hospitalization ( B ), MACCE ( C ), and major/life-threatening bleeding events ( D ) in four groups according to AF and postprocedural CT-ADP >180 seconds. A drastic increase of bleeding events was evidenced in patients with AF + CT-ADP >180 seconds. AF, atrial fibrillation; CT-ADP, closure time adenosine diphosphate; MACCE, major adverse cardiac and cerebrovascular events.

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  Fig. 4.. Multivariate Cox regression analyses illustrate that patients with AF and ongoing primary hemostatic disorder (postprocedural CT-ADP >180 seconds) were associated with an increased risk of major/life-threatening bleeding complications at follow-up, whereas no impact was evidenced in MACCE. CT-ADP, closure time adenosine diphosphate; MACCE, major adverse cardiac and cerebrovascular events.

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  Fig. 5.. Cumulative event rates of late major/life-threatening bleeding events (>30 days after TAVR) in AF and non-AF patients ( A ), in four groups according to AF and postprocedural CT-ADP >180 seconds ( B ), in patients with and without OAC ( C ), and in four groups according to the use of OAC at discharge and postprocedural CT-ADP >180 seconds ( D ). AF, atrial fibrillation; CT-ADP, closure time adenosine diphosphate; OAC, oral anticoagulant; TAVR, transcatheter aortic valve replacement.