PMID- 33909348
OWN - NLM
STAT- MEDLINE
DCOM- 20211203
LR  - 20211214
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 98
IP  - 6
DP  - 2021 Nov 15
TI  - Impact of anemia on short-term outcomes after TAVR: A subgroup analysis from the 
      BRAVO-3 randomized trial.
PG  - E870-E880
LID - 10.1002/ccd.29753 [doi]
AB  - OBJECTIVES: To determine the prognostic impact of anemia in patients randomized 
      to bivalirudin or unfractionated heparin (UFH) during transcatheter aortic valve 
      replacement (TAVR). BACKGROUND: Whether the periprocedural use of bivalirudin as 
      compared with UFH in anemic patients undergoing TAVR has an impact on outcomes 
      remains unknown. METHODS: The BRAVO-3 trial compared the use of bivalirudin 
      versus UFH in 802 high risk patients undergoing transfemoral TAVR for severe 
      symptomatic aortic stenosis. Patients were stratified according to the presence 
      (defined as hemoglobin levels <13 g/dl in men and <12 g/dl in women) or absence 
      of anemia. The primary outcomes were net adverse cardiac events (NACE; a 
      composite of all-cause mortality, myocardial infarction, stroke, or bleeding) and 
      major bleeding (Bleeding Academic Research Consortium >/=3b) at 30 days. RESULTS: 
      Among 798 patients with available baseline hemoglobin levels, 427 (54%) were 
      anemic of whom 221 (52%) received bivalirudin. There were no significant 
      differences in NACE and major bleeding at 30 days between patients with and 
      without anemia, irrespective of the type of anticoagulant used (p(interaction) 
       = 0.71 for NACE, p(interaction)  = 1.0 for major bleeding). However, anemic 
      patients had a higher risk of major vascular complications (adjusted OR 2.43, 95% 
      CI 1.42-4.16, p = 0.001), and acute kidney injury (adjusted OR 1.74, 95% CI 
      1.16-2.59, p = 0.007) compared to non-anemic patients at 30 days. CONCLUSIONS: 
      Anemia was not associated with a higher risk of NACE or major bleeding at 30 days 
      after TAVR without modification of the treatment effects of periprocedural 
      anticoagulation with bivalirudin versus UFH.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Razuk, Victor
AU  - Razuk V
AUID- ORCID: 0000-0001-9385-9233
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Camaj, Anton
AU  - Camaj A
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Cao, Davide
AU  - Cao D
AUID- ORCID: 0000-0001-7755-4069
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Nicolas, Johny
AU  - Nicolas J
AUID- ORCID: 0000-0002-3015-3361
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Hengstenberg, Christian
AU  - Hengstenberg C
AD  - Department of Internal Medicine II, Division of Cardiology, Medical University of 
      Vienna, Vienna, Austria.
FAU - Sartori, Samantha
AU  - Sartori S
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Zhang, Zhongjie
AU  - Zhang Z
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Power, David
AU  - Power D
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Beerkens, Frans
AU  - Beerkens F
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Chiarito, Mauro
AU  - Chiarito M
AUID- ORCID: 0000-0002-9333-2658
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Meneveau, Nicolas
AU  - Meneveau N
AD  - Department of Cardiology, University Hospital Jean Minjoz, Besancon, France.
FAU - Tron, Christophe
AU  - Tron C
AD  - Division of Cardiology, Rouen University Hospital, Rouen, France.
FAU - Dumonteil, Nicolas
AU  - Dumonteil N
AD  - Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France.
FAU - Widder, Julian D
AU  - Widder JD
AD  - Department of Cardiology and Angiology, Hannover Medical School, Hannover, 
      Germany.
FAU - Ferrari, Markus
AU  - Ferrari M
AD  - Interventional Cardiology, Helios Dr. Horst Schmidt Kliniken Wiesbaden, 
      Wiesbaden, Germany.
FAU - Violini, Roberto
AU  - Violini R
AD  - Interventional Cardiology Unit, San Camillo Hospital, Rome, Italy.
FAU - Stella, Pieter R
AU  - Stella PR
AD  - Department of Cardiology, University Medical Center Utrecht, Utrecht, the 
      Netherlands.
FAU - Jeger, Raban
AU  - Jeger R
AD  - Department of Cardiology, University Hospital Basel, University of Basel, 
      Switzerland.
FAU - Anthopoulos, Prodromos
AU  - Anthopoulos P
AD  - European Medical, Arena Pharmaceuticals Inc, Zurich, Switzerland.
FAU - Mehran, Roxana
AU  - Mehran R
AUID- ORCID: 0000-0002-5546-262X
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
FAU - Dangas, George D
AU  - Dangas GD
AUID- ORCID: 0000-0001-7502-8049
AD  - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine 
      at Mount Sinai, New York, New York, USA.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20210512
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
RN  - 0 (Antithrombins)
RN  - 0 (Nitriles)
RN  - 9005-49-6 (Heparin)
RN  - J718M71A7A (tetrachloroisophthalonitrile)
SB  - IM
MH  - *Anemia/diagnosis
MH  - Antithrombins
MH  - *Aortic Valve Stenosis/diagnostic imaging/surgery
MH  - Female
MH  - Heparin
MH  - Humans
MH  - Male
MH  - Nitriles
MH  - *Transcatheter Aortic Valve Replacement/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - TAVI
OT  - TAVR
OT  - anemia
OT  - bivalirudin
OT  - heparin
EDAT- 2021/04/29 06:00
MHDA- 2021/12/15 06:00
CRDT- 2021/04/28 12:33
PHST- 2021/04/25 00:00 [received]
PHST- 2021/04/26 00:00 [accepted]
PHST- 2021/04/29 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/04/28 12:33 [entrez]
AID - 10.1002/ccd.29753 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2021 Nov 15;98(6):E870-E880. doi: 10.1002/ccd.29753. 
      Epub 2021 May 12.