Magri Caroline J, Chieffo Alaide, Durante Alessandro, Latib Azeem, Montorfano Matteo, Maisano Francesco, Cioni Michela, Agricola Eustachio, Covello Remo Daniel, Gerli Chiara, Franco Annalisa, Spagnolo Pietro, Alfieri Ottavio, Colombo Antonio
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Biomed Res Int. 2013;2013:645265. doi: 10.1155/2013/645265. Epub 2013 Dec 23.
Vascular and bleeding complications remain important complications in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI). Platelets play an important role in bleeding events. Mean platelet volume (MPV) is an indicator of platelet activation. The objective of this study was to assess whether low MPV is an indicator of major vascular and bleeding complications following TF-TAVI.
A retrospective cohort study of 330 subjects undergoing TF-TAVI implantation was performed. The primary study endpoint was the occurrence of combined safety endpoint (CSEP); secondary endpoints included major vascular complications and life-threatening bleeding. Endpoints were defined according to Valve Academic Research Consortium 2.
The CSEP at 30 days was reached in 30.9%; major vascular complications were observed in 14.9% while life-threatening bleeding occurred in 20.6%. Logistic Euroscore and MPV were independent predictors of CSEP. Predictors of vascular complications were female sex, previous myocardial infarction, red blood cell distribution width (RDW), and MPV while predictors of life-threatening bleeding were peripheral arterial disease, RDW, and MPV.
A low baseline MPV was shown for the first time to be a significant predictor of CSEP, major vascular complications, and life-threatening bleeding following TF-TAVI.
血管和出血并发症仍是经皮股动脉经导管主动脉瓣植入术(TF-TAVI)患者的重要并发症。血小板在出血事件中起重要作用。平均血小板体积(MPV)是血小板活化的指标。本研究的目的是评估低MPV是否是TF-TAVI术后主要血管和出血并发症的指标。
对330例行TF-TAVI植入术的受试者进行回顾性队列研究。主要研究终点是联合安全终点(CSEP)的发生;次要终点包括主要血管并发症和危及生命的出血。终点根据瓣膜学术研究联盟2进行定义。
30天时达到CSEP的比例为30.9%;观察到主要血管并发症的比例为14.9%,危及生命的出血发生率为20.6%。逻辑欧洲心脏手术风险评估系统(Logistic Euroscore)和MPV是CSEP的独立预测因素。血管并发症的预测因素为女性、既往心肌梗死、红细胞分布宽度(RDW)和MPV,而危及生命出血的预测因素为外周动脉疾病、RDW和MPV。
首次表明低基线MPV是TF-TAVI术后CSEP、主要血管并发症和危及生命出血的重要预测因素。