Key result
Pre-procedural haemolysis in TAVI candidates linked to ~123% increase in 30-day adverse events.
Why the study?
The prevalence of haemolysis in patients with severe aortic stenosis undergoing TAVI and its association with immediate and 30-day post-procedural outcomes was not well characterized.
Does pre-procedural subclinical haemolysis increase the risk of peri-procedural and 30-day adverse events in patients with severe aortic stenosis undergoing TAVI?
Cohort (n=301)
No
Does pre-procedural subclinical haemolysis increase the risk of peri-procedural and 30-day adverse events in patients with severe aortic stenosis undergoing TAVI?
Pre-procedural subclinical haemolysis is present in 6% of TAVI candidates and is independently associated with a more than twofold increased risk of peri-procedural and 30-day adverse events.
Answers are grounded in this paper and cite their sources.
Subclinical haemolysis was associated with higher TAVI risk; leaves open whether screening or mitigation improves outcomes.
Background Transcatheter aortic valve implantation (TAVI) has become a cornerstone treatment for patients with severe aortic stenosis, especially those unsuitable for surgery. Intravascular haemolysis has been described in patients with aortic stenosis. This study aimed to assess the prevalence of haemolysis in patients with severe AS undergoing TAVI and its association with immediate and 30-day post-procedural outcomes. Methods The HEMO-TAVI study was a prospective, single-centre cohort study conducted at University Hospital Reina Sofía (Córdoba, Spain) from June 2020 to September 2023. Consecutive patients scheduled for TAVI were enrolled. Haemolysis was defined as LDH > 220 U/L plus ≥2 criteria (low haemoglobin, low haptoglobin, elevated reticulocytes, or schistocytes). The primary endpoint was a composite of peri-procedural and 30-day adverse events. Results Among 301 patients, pre-procedural haemolysis was identified in 18 (6.0%). Patients with haemolysis had higher interventricular septum thickness and transvalvular gradients. The composite endpoint occurred more frequently in the haemolysis group (44.4% vs 21.2%, OR adj 2.23, 95% CI 1.12–8.25, p = 0.025). Haemolysis was independently associated with a greater number of complications (OR adj 3.26, 95% CI 1.19–8.47, p = 0.016). Conclusion Pre-procedural haemolysis might be present in TAVI candidates and is associated with increased peri-procedural and 30-day complications. Pre-procedural haemolysis may serve as a marker of elevated procedural risk.
No takes yet. Share an insight, caveat, or question.
Heredia-Campos et al. (2025) conducted a cohort in Severe aortic stenosis (n=301). Pre-procedural haemolysis vs. No pre-procedural haemolysis was evaluated on Composite of peri-procedural and 30-day adverse events (OR adj 2.23, 95% CI 1.12-8.25, p=0.025). Pre-procedural haemolysis in TAVI candidates was associated with increased peri-procedural and 30-day adverse events compared to no haemolysis.
Synapse has enriched 10 related papers. Consider them for comparative context: