Valvular & structural heart disease
Prevalence and prognostic implications of the Valve Academic Research Consortium-High Bleeding Risk criteria in patients undergoing transcatheter aortic valve implantation
Authors' conclusion
Up to 60% of patients undergoing TAVI are at high or very high bleeding risk. The VARC-HBR criteria identified those at greater risk of adverse events. In-hospital bleeding complications and long-term cardiovascular events increased progressively across VARC-HBR categories.
Study context
- Population
- Patients undergoing transcatheter aortic valve implantation (TAVI) included in the Transfusion Requirements in Transcatheter Aortic Valve Implantation registry
- Participants
- 8,464 patients
- Exposure
- Low, moderate, high or very high bleeding risk using the VARC-HBR criteria
- Very highn = 1,966
- Highn = 3,311
- Moderaten = 2,075
- Lown = 1,112
- Outcome
- In-hospital major or life-threatening bleeding (VARC-2 definition)
- Follow-up
- In-hospital
Methodological details18 European sites, between 2007 and 2022
- 18 European sites
- Between 2007 and 2022
Main finding
As reported in the abstract
- P across categories
- P < 0.001
Observational data: associations, not effects.
Further findings
Major adverse cardiovascular events · 2 years
Distribution of bleeding risk
| Outcome | HR (95% CI) | |
|---|---|---|
| Mortality after a bleeding eventBleeding eventvs no bleeding eventOverall | 1.71 (1.50–1.95) | |
| Mortality after a bleeding eventBleeding eventvs no bleeding eventWithin the first 3 months | 2.88 (2.33–3.56) | |
| 0.20.5125Hazard ratio (log scale) |
- Major adverse cardiovascular events — P across categories
- p<0.001
Original publication
Prevalence and prognostic implications of the Valve Academic Research Consortium-High Bleeding Risk criteria in patients undergoing transcatheter aortic valve implantation. Heart. Published 12 August 2025. doi:10.
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