title: Acquired thrombocytopenia after transcatheter aortic valve replacement: clinical correlates and association with outcomes.
abstract: OBJECTIVE
  This study aimed to evaluate incidence and correlates for low platelet count after transcatheter aortic valve replacement (TAVR) and to determine a possible association between acquired thrombocytopenia and clinical outcomes.
  
  
  RESULTS
  Patients undergoing TAVR from two medical centres were included in the study. They were stratified according to nadir platelet count post procedure: no/mild thrombocytopenia, ≥100 × 10(9)/L; moderate, 50-99 × 10(9)/L; and severe, <50 × 10(9)/L. A total of 488 patients composed of the study population (age 84.7 ± 7.5 years). At a median time of 2 days after TAVR, 176 patients (36.1%) developed significant thrombocytopenia: 149 (30.5%) moderate; 27 patients (5.5%) severe. Upon discharge, the vast majority of patients (90.2%) had no/mild thrombocytopenia. Nadir platelet count <50 × 10(9)/L was highly specific (96.3%), and a count <150 × 10(9)/L highly sensitive (91.2%), for predicting 30-day death (C-statistic 0.76). Patients with severe acquired thrombocytopenia had a significantly higher mortality rate at 1 year (66.7% for severe vs. 16.0% for no/mild vs. 20.1% for moderate; P < 0.001). In multivariate logistic regression, severe thrombocytopenia was independently associated with 1-year mortality (hazard ratio 3.44, CI: 1.02-11.6; P = 0.046).
  
  
  CONCLUSIONS
  Acquired thrombocytopenia was common after TAVR and was mostly resolved at patient discharge. The severity of thrombocytopenia after TAVR could be used as an excellent, easily obtainable, marker for worse short- and long-term outcomes after the procedure.
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Danny
authors.initials: D
authors.lastname: Dvir
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Généreux
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Israel M
authors.initials: IM
authors.lastname: Barbash
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Susheel
authors.initials: S
authors.lastname: Kodali
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Itsik
authors.initials: I
authors.lastname: Ben-Dor
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Mathew
authors.initials: M
authors.lastname: Williams
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Sa'ar
authors.initials: S
authors.lastname: Minha
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Salem
authors.initials: S
authors.lastname: Badr
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Lakshmana K
authors.initials: LK
authors.lastname: Pendyala
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Loh
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Petros G
authors.initials: PG
authors.lastname: Okubagzi
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Fields
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Hahn
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Smith
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.affiliation: Columbia University Medical Center and The Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.affiliation: MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA ron.waksman@gmail.com.
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010976:Platelet Count; D013921:Thrombocytopenia / Q000209:etiology*; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Thrombocytopenia; Transcatheter aortic valve replacement