Bleeding Linked to Mortality Risk After TAVR

Mortality risk was associated with access site and non-access site bleeding among patients who underwent transcatheter aortic valve replacement (TAVR), according to a recent study.

The study included 926 patients who underwent TAVR. All-cause mortality was assessed as the primary outcome, and bleeding was evaluated using the Valve Academic Research Consortium 2 criteria.
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During the 5 years of follow-up, 285 patients (30.7%) experienced as least 1 bleeding event.

Patients who experienced bleeding at the access site or at a non-access site had a significantly higher risk for all-cause mortality compared with patients who did not experience bleeding (hazard ratio [HR] 1.34 and HR 2.08, respectively). Those who experienced non-access site bleeding had a significantly higher risk than those who experienced bleeding at the access site (HR 1.56).

In multivariate analyses, female sex was significantly associated with access-site bleeding, and the Society of Thoracic Surgeons score and chronic kidney disease were significantly associated with non-access site bleeding.

“Among patients with severe aortic stenosis undergoing TAVR, access-site and non-access-site bleeding were independently associated with an increased risk for mortality, with the greatest risk related to non-access-site bleeding during long-term follow-up,” the researchers concluded.

—Melissa Weiss

Reference:

Piccolo R, Pilgrim T, Franzone A, et al. Frequency, timing, and impact of access-site and non–access-site bleeding on mortality among patients undergoing transcatheter aortic valve replacement. JACC Cardiovasc Interv. 2017; 10(14): 1436-1446.