title: Prevalence and prognostic implications of baseline anaemia in patients undergoing transcatheter aortic valve implantation.
abstract: OBJECTIVE
  TAVI is a minimally invasive alternative to surgical aortic valve replacement or medical therapy in patients with a high or prohibitive operative risk. The clinical significance of baseline anemia and prognostic implications in this patient cohort are unknown. We sought to evaluate the prevalence and prognostic implications of baseline anaemia in patients undergoing transcatheter aortic valve implantation (TAVI) at our institution.
  
  
  RESULTS
  One hundred and eighteen consecutive patients who underwent TAVI with the Medtronic Corevalve System (Medtronic Corp., Minneapolis, MN, USA) were included in the analysis. Clinical and biochemical data were prospectively collected before, during and after the procedure. Clinical follow-up was set at one month, one year and yearly thereafter. Anaemia was defined as a haemoglobin level <13 g/dL in men and <12 g/dL in women. Mortality was confirmed by consultation of the civil registry. The prevalence of baseline anaemia was 49%. Anaemic patients undergoing TAVI required more RBC transfusions (3.3 ± 3.1 versus 1.5 ± 2.3; p<0.001) and more frequently experienced a prolonged index hospitalisation exceeding two weeks. For patients with at least 1-year follow up (N=74), mortality at 30 days was no different; however 1-year mortality was significantly higher in the anaemic cohort (44 versus 15%, p=0.006). In a multivariable analysis, baseline anaemia emerged as an independent predictor of 1- year mortality (HR 2.10 [1.06-4.18]).
  
  
  CONCLUSIONS
  In our series, baseline anaemia is common in patients undergoing TAVI, forecasts a need for more red blood cell transfusions and is associated with increased 1-year mortality.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Van Mieghem
authors.forename: Rutger-Jan
authors.initials: RJ
authors.lastname: Nuis
authors.forename: Apostolos
authors.initials: A
authors.lastname: Tzikas
authors.forename: Nicolo
authors.initials: N
authors.lastname: Piazza
authors.forename: Carl
authors.initials: C
authors.lastname: Schultz
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Peter P
authors.initials: PP
authors.lastname: de Jaegere
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology* / Q000401:mortality; D001021:Aortic Valve / Q000601:surgery*; D001803:Blood Transfusion; D006328:Cardiac Catheterization; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006801:Humans; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies