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• W3215053251 abstract "Background and Objectives: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement for the therapeutic treatment of severe aortic stenosis. However, intraprocedural hemodynamic assessment by echocardiography is not always optimal and new tools are needed. A new approach using the blood biomarker measuring platelet occlusion time (CT-ADP) and more specifically its change between the pre-intervention and post-intervention (ΔCT-ADP) could be useful to overcome the lack of accuracy of echocardiography, but also to prevent adverse clinical events following TAVI. The objective of this study is to examine the association between ΔCT-ADP and i) intraprocedural valve hemodynamic performance; and ii) occurrence of all-cause death and rehospitalization for heart failure (HF) in TAVI patients. Methods: Three hundred and thirty-eight patients who underwent TAVI at our institute were recruited. Clinical and echocardiographic data were collected before and after the procedure. Two blood samples were collected prior to- and at the end of- TAVI to assess the immediate changes (Δ: pre minus post) in CT-ADP following TAVI. A percentage (Δ/pre-intervention value) was determined for CT-ADP and mean gradient (MG) for each patient. Results: Prior to TAVI, 135(40.0%) patients had a prolonged CT-ADP (>180 s). There was a significant but modest correlation between ΔCT-ADP and the change in mean transvalvular gradient immediately after TAVI (r=0.15, p=0.007). A ΔCT-ADP (i.e. decrease) >10% (i.e. median of cohort) was associated with a higher rate of transcatheter valve regurgitation ≥ moderate (0.0% vs 3.0%, p=0.030) following TAVI, and a longer length of hospital stay (7.8±8.3 vs. 9.7±9.0 days, p=0.002). During a median follow-up of 1.2 (1.0-2.4) years, there were 87 clinical events (30 rehospitalizations and 57 deaths). A ΔCT-ADP >10% tended toward higher risk of events in univariable analysis (HR[95%CI]: 1.49[0.94-2.37], p=0.090), but not after adjustment for other risk factors (HR[95%CI]: 1.10[0.53-2.28], p=0.79). Conclusion: A >10% decrease in CT-ADP immediately after TAVI is associated with worse hemodynamic outcomes. This association is not independent and appears to be related to other risk factors." @default.
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• W3215053251 date "2021-11-16" @default.
• W3215053251 modified "2023-10-17" @default.
• W3215053251 title "Abstract 12973: Intra-Procedural Change in Platelet Occlusion Time to Predict Hemodynamic and Clinical Outcomes Following Transcatheter Aortic Valve Replacement" @default.
• W3215053251 doi "https://doi.org/10.1161/circ.144.suppl_1.12973" @default.
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