Prognostic impact of anemia and iron-deficiency anemia in a contemporary cohort of patients undergoing transcatheter aortic valve implantation

Tobias Rheude, Costanza Pellegrini, Jonathan Michel, Teresa Trenkwalder, N. Patrick Mayr, Thorsten Kessler, Albert M. Kasel, Heribert Schunkert, Adnan Kastrati, Christian Hengstenberg, Oliver Husser

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37 Scopus citations

Abstract

Introduction Anemia is frequent in patients undergoing transcatheter aortic valve implantation (TAVI) with a strong negative prognostic impact. The prevalence and prognosis of anemia and separately of iron-deficiency anemia in contemporary patients are unclear. Methods and results In total, 549 consecutive patients undergoing transfemoral TAVI were included in the single-center study. Baseline anemia was defined as a hemoglobin level < 13 g/dL in men and < 12 g/dL in women. In an unselected subgroup of anemic patients (n = 115), a complete iron status was obtained and anemia was classified as iron-deficiency versus non-iron-deficiency. The primary endpoint was death or re-hospitalization for worsening heart failure within one year after TAVI. Anemia was present in 45% (249/549) of the population and was significantly associated with a higher rate of the primary endpoint (25% (63/249) vs. 8% (25/300); p < 0.001). In a multivariable model adjusted for variables associated with the primary endpoint, baseline anemia was an independent predictor of the primary endpoint (hazard ratio 2.81, 95% confidence interval [1.69–4.67]; p < 0.001). Iron-deficiency anemia was present in 79% (91/115) of the subgroup and the rate of the primary endpoint was comparable to non-iron-deficiency anemia (31% (28/91) vs. 21% (5/24); p = 0.338). Conclusion In contemporary TAVI patients, anemia remains a common comorbidity and independently predicts adverse outcome. In an unselected subgroup of anemic patients, iron-deficiency was common and had similar clinical outcome compared to non-iron-deficiency. Whether correction of iron-deficiency anemia impacts prognosis remains to be investigated.

Original languageEnglish
Pages (from-to)93-99
Number of pages7
JournalInternational Journal of Cardiology
Volume244
DOIs
StatePublished - 1 Oct 2017

Keywords

  • Anemia
  • Aortic stenosis
  • TAVI
  • Transcatheter aortic valve implantation

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