Universität zu Köln

Lother, Achim, Kaier, Klaus ORCID: 0000-0003-0837-6945, Ahrens, Ingo, Bothe, Wolfgang, Wolf, Dennis ORCID: 0000-0003-1525-4348, Zehender, Manfred, Bode, Christoph, Muehlen, Constantin von zur and Stachon, Peter (2020). Bleeding Complications Drive In-Hospital Mortality of Patients with Atrial Fibrillation after Transcatheter Aortic Valve Replacement. Thromb. Haemost., 120 (11). S. 1580 - 1587. STUTTGART: GEORG THIEME VERLAG KG. ISSN 2567-689X

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Abstract

Background Atrial fibrillation (AF) is a risk factor for poor postoperative outcome after transfemoral transcatheter aortic valve replacement (TF-TAVR). The present study analyses the outcomes after TF-TAVR in patients with or without AF and identifies independent predictors for in-hospital mortality in clinical practice. Methods and Results Among all 57,050 patients undergoing isolated TF-TAVR between 2008 and 2016 in Germany, 44.2% of patients (n = 25,309) had AF. Patients with AF were at higher risk for unfavorable in-hospital outcome after TAVR. Including all baseline characteristics for a risk-adjusted comparison, AF was an independent risk factor for in-hospital mortality after TAVR. Among patients with AF, EuroSCORE, New York Heart Association classification class, or renal disease had only moderate effects on mortality, while the occurrence of postprocedural stroke or moderate to major bleeding substantially increased in-hospital mortality (odds ratio [OR] 3.35, 95% confidence interval [CI] 2.61-4.30,p < 0.001 and OR 3.12, 95% CI 2.68-3.62,p < 0.001). However, the strongest independent predictor for in-hospital mortality among patients with AF was severe bleeding (OR 18.00, 95% CI 15.22-21.30,p < 0.001). Conclusion The present study demonstrates that the incidence of bleeding defines the in-hospital outcome of patients with AF after TF-TAVR. Thus, the periprocedural phase demands particular care in bleeding prevention.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lother, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaier, Klaus UNSPECIFIED orcid.org/0000-0003-0837-6945 UNSPECIFIED Ahrens, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Bothe, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Dennis UNSPECIFIED orcid.org/0000-0003-1525-4348 UNSPECIFIED Zehender, Manfred UNSPECIFIED UNSPECIFIED UNSPECIFIED Bode, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Muehlen, Constantin von zur UNSPECIFIED UNSPECIFIED UNSPECIFIED Stachon, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-322809
DOI:	10.1055/s-0040-1715833
Journal or Publication Title:	Thromb. Haemost.
Volume:	120
Number:	11
Page Range:	S. 1580 - 1587
Date:	2020
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	2567-689X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IMPACT; OUTCOMES; RISK; IMPLANTATION; ASSOCIATION; PREDICTORS; MANAGEMENT Multiple languages Hematology; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32280