Coronary disease & ACSCohort study
Late Bleeding Events in Patients Undergoing Percutaneous Coronary Intervention in the Workup Pre-TAVR
- Multicentre cohort study
- consecutive patients
Authors' conclusion
In TAVR candidates with concomitant significant coronary artery disease requiring percutaneous treatment, LBEs after TAVR were frequent and associated with increased mortality. Combining antiplatelet and anticoagulation regimens and the occurrence of periprocedural bleeding determined an increased risk of LBEs.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI) in the work-up pre-TAVR who underwent TAVR and survived beyond 30 days (mean age 81 ± 7 years; 41.5% women)
- Participants
- 1,457 consecutive patients
- Exposure
- Late bleeding events (LBEs) vs no bleeding
- LBEsn = 116
- Outcome
- Incidence, characteristics, associated factors and outcomes of LBEs
Main finding
As reported in the abstract
Incidence of LBEs · median follow-up 23 (IQR: 12-40) months
| Group | Value | Minor | Major | Life-threatening or disabling |
|---|---|---|---|---|
| LBEs | 7.9% | 21 (18.1%) | 63 (54.3%) | 32 (27.6%) |
Observational data: associations, not effects.
Further findings
| Outcome | LBEs | No bleeding | P value |
|---|---|---|---|
| Mortality · 4-year follow-up | 43.9% | 36.0 | P = 0.034 |
Severity of late bleeding
- Minor
- 21 (18.1%)
- Major
- 63 (54.3%)
- Life-threatening or disabling
- 32 (27.6%)
Independent factors associated with LBEs
- Periprocedural (<30 days post-TAVR) major bleeding and antiplatelet + anticoagulation therapy at discharge
- P ≤ 0.02 for all
All-cause mortality after TAVR (independent predictor)
- LBE independent predictor of all-cause mortality, HR 1.39 (95% CI 1.05-1.83)
- P = 0.020
Original publication
Late Bleeding Events in Patients Undergoing Percutaneous Coronary Intervention in the Workup Pre-TAVR. JACC Cardiovasc Interv. Published 11 September 2023. doi:10.1016/j.jcin.2023.06.037
Summarised from the published abstract; every number is checked against it