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Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement
BACKGROUND: Bleeding following transcatheter aortic valve replacement (TAVR) has important prognostic implications. This study sought to evaluate the impact of baseline mean platelet volume (MPV) on bleeding events after TAVR. METHODS AND RESULTS: Patients undergoing TAVR between February 2010 and M...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631672/ https://www.ncbi.nlm.nih.gov/pubmed/34847152 http://dx.doi.org/10.1371/journal.pone.0260439 |
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author | Trimaille, Antonin Matsushita, Kensuke Marchandot, Benjamin Carmona, Adrien Hess, Sébastien Kibler, Marion Heger, Joé Reydel, Antje Sattler, Laurent Grunebaum, Lelia Jesel, Laurence Ohlmann, Patrick Morel, Olivier |
author_facet | Trimaille, Antonin Matsushita, Kensuke Marchandot, Benjamin Carmona, Adrien Hess, Sébastien Kibler, Marion Heger, Joé Reydel, Antje Sattler, Laurent Grunebaum, Lelia Jesel, Laurence Ohlmann, Patrick Morel, Olivier |
author_sort | Trimaille, Antonin |
collection | PubMed |
description | BACKGROUND: Bleeding following transcatheter aortic valve replacement (TAVR) has important prognostic implications. This study sought to evaluate the impact of baseline mean platelet volume (MPV) on bleeding events after TAVR. METHODS AND RESULTS: Patients undergoing TAVR between February 2010 and May 2019 were included. Low MPV (L-MPV) was defined as MPV ≤10 fL and high MPV (H-MPV) as MPV >10 fL. The primary endpoint was the occurrence of major/life-threatening bleeding complications (MLBCs) at one-year follow-up. Among 1,111 patients, 398 (35.8%) had L-MPV and 713 (64.2%) had H-MPV. The rate of MLBCs at 1 year was higher in L-MPV patients compared with H-MPV patients (22.9% vs. 17.7% respectively, p = 0.034). L-MPV was associated with vascular access-site complications (36.2% vs. 28.9%, p = 0.012), early (<30 days) major bleeding (15.6% vs. 9.4%, p<0.01) and red blood cell transfusion >2 units (23.9% vs. 17.5%, p = 0.01). No impact of baseline MPV on overall death, cardiovascular death and ischemic events (myocardial infarction and stroke) was evidenced. Multivariate analysis using Fine and Gray model identified preprocedural hemoglobin (sHR 0.84, 95%CI [0.75–0.93], p = 0.001), preprocedural L-MPV (sHR 1.64, 95%CI [1.16–2.32], p = 0.005) and closure time adenosine diphosphate post-TAVR (sHR 2.71, 95%CI [1.87–3.95], p<0.001) as predictors of MLBCs. CONCLUSIONS: Preprocedural MPV was identified as an independent predictor of MLBCs one year after TAVR, regardless of the extent of platelet inhibition and primary hemostasis disorders. |
format | Online Article Text |
id | pubmed-8631672 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-86316722021-12-01 Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement Trimaille, Antonin Matsushita, Kensuke Marchandot, Benjamin Carmona, Adrien Hess, Sébastien Kibler, Marion Heger, Joé Reydel, Antje Sattler, Laurent Grunebaum, Lelia Jesel, Laurence Ohlmann, Patrick Morel, Olivier PLoS One Research Article BACKGROUND: Bleeding following transcatheter aortic valve replacement (TAVR) has important prognostic implications. This study sought to evaluate the impact of baseline mean platelet volume (MPV) on bleeding events after TAVR. METHODS AND RESULTS: Patients undergoing TAVR between February 2010 and May 2019 were included. Low MPV (L-MPV) was defined as MPV ≤10 fL and high MPV (H-MPV) as MPV >10 fL. The primary endpoint was the occurrence of major/life-threatening bleeding complications (MLBCs) at one-year follow-up. Among 1,111 patients, 398 (35.8%) had L-MPV and 713 (64.2%) had H-MPV. The rate of MLBCs at 1 year was higher in L-MPV patients compared with H-MPV patients (22.9% vs. 17.7% respectively, p = 0.034). L-MPV was associated with vascular access-site complications (36.2% vs. 28.9%, p = 0.012), early (<30 days) major bleeding (15.6% vs. 9.4%, p<0.01) and red blood cell transfusion >2 units (23.9% vs. 17.5%, p = 0.01). No impact of baseline MPV on overall death, cardiovascular death and ischemic events (myocardial infarction and stroke) was evidenced. Multivariate analysis using Fine and Gray model identified preprocedural hemoglobin (sHR 0.84, 95%CI [0.75–0.93], p = 0.001), preprocedural L-MPV (sHR 1.64, 95%CI [1.16–2.32], p = 0.005) and closure time adenosine diphosphate post-TAVR (sHR 2.71, 95%CI [1.87–3.95], p<0.001) as predictors of MLBCs. CONCLUSIONS: Preprocedural MPV was identified as an independent predictor of MLBCs one year after TAVR, regardless of the extent of platelet inhibition and primary hemostasis disorders. Public Library of Science 2021-11-30 /pmc/articles/PMC8631672/ /pubmed/34847152 http://dx.doi.org/10.1371/journal.pone.0260439 Text en © 2021 Trimaille et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Trimaille, Antonin Matsushita, Kensuke Marchandot, Benjamin Carmona, Adrien Hess, Sébastien Kibler, Marion Heger, Joé Reydel, Antje Sattler, Laurent Grunebaum, Lelia Jesel, Laurence Ohlmann, Patrick Morel, Olivier Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement |
title | Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement |
title_full | Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement |
title_fullStr | Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement |
title_full_unstemmed | Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement |
title_short | Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement |
title_sort | baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8631672/ https://www.ncbi.nlm.nih.gov/pubmed/34847152 http://dx.doi.org/10.1371/journal.pone.0260439 |
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