Valvular & structural heart disease
Incidence, predictors and clinical impact of upper gastrointestinal bleeding after transcatheter aortic valve replacement
Authors' conclusion
Among patients who underwent TAVR, 1.7% of patients experienced upper GI bleeding within 1 year of discharge. Major or life-threatening upper GI bleeding was associated with an increased risk of all-cause and cardiovascular mortality.
Study context
- Population
- Patients undergoing transcatheter aortic valve replacement (TAVR), prospective TAVR registryeligible
- Participants
- 3,144 patients
- Exposure
- Upper gastrointestinal (GI) bleeding vs no upper GI bleeding within 1 year of discharge
- Upper GI bleedingn = 54
- Outcome
- Incidence of upper GI bleeding after discharge
- Follow-up
- Within 1 year of discharge
Main finding
As reported in the abstract
Upper GI bleeding after discharge
Upper GI bleeding
1.7%
54 of 54
- Major or life-threatening bleeding
- 40
- Minor bleeding
- 14
Observational data: associations, not effects.
Further findings
| Outcome | Upper GI bleeding | No upper GI bleeding | Estimate | |
|---|---|---|---|---|
| Independent predictors of upper GI bleeding · within 1 year of discharge — Atrial fibrillation or atrial flutter vs No upper GI bleeding | adjusted HR 2.98 (95% CI 1.65–5.38) | |||
| Independent predictors of upper GI bleeding · within 1 year of discharge — Previous upper GI bleeding vs No upper GI bleeding | adjusted HR 3.51 (95% CI 1.51–8.19) | |||
| Independent predictors of upper GI bleeding · within 1 year of discharge — Proton pump inhibitors at discharge vs No upper GI bleeding · protective | adjusted HR 0.49 (95% CI 0.27–0.89) | |||
| Independent predictors of upper GI bleeding · within 1 year of discharge — Higher haemoglobin (1 g/dL increase) vs No upper GI bleeding · protective | adjusted HR 0.73 (95% CI 0.62–0.87) | |||
| All-cause mortality | Not reported in the abstract | 11.4% | HR 5.84 (95% CI 3.41–10.02) | Upper GI bleeding: not reported in the abstract |
| CV mortality | Not reported in the abstract | 7.3% | HR 3.87 (95% CI 1.72–8.70) | Upper GI bleeding: not reported in the abstract |
| 0.050.21520Ratio (log scale) |
- All-cause mortality: Major or life-threatening upper GI bleeding 73.7%
- CV mortality: Major or life-threatening upper GI bleeding 31.6%
Original publication
Incidence, predictors and clinical impact of upper gastrointestinal bleeding after transcatheter aortic valve replacement. Heart. Published 10 May 2025. doi:10.
Summarised from the published abstract; every number is checked against it