Impact of mean platelet volume on combined safety endpoint and vascular and bleeding complications following percutaneous transfemoral transcatheter aortic valve implantation.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Caroline J
CJ
Magri
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Alaide
A
Chieffo
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Alessandro
A
Durante
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Azeem
A
Latib
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Matteo
M
Montorfano
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Francesco
F
Maisano
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Michela
M
Cioni
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Eustachio
E
Agricola
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Remo Daniel
RD
Covello
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Chiara
C
Gerli
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Annalisa
A
Franco
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Pietro
P
Spagnolo
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Ottavio
O
Alfieri
Interventional Cardiology Unit, San Raffaele Scientific Institute, 60 Via Olgettina, 20132 Milan, Italy.
Antonio
A
Colombo
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D006470:Hemorrhage / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume; D009203:Myocardial Infarction / Q000150:complications / Q000473:pathology / Q000601:surgery; D019736:Prostheses and Implants; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000473:pathology / Q000601:surgery*