title: Recovery from anemia in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation--prevalence, predictors and clinical outcome.
abstract: BACKGROUND
  Preoperative anemia is common in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and has been linked to a poorer outcome--including a higher 1-year mortality. The aim of this study was to investigate the impact of successful TAVI on baseline anemia.
  
  
  METHODS
  A total of 253 patients who survived at least 1 year following TAVI were included in this study. The prevalence, predictors and clinical outcome of hemoglobin (Hb)-recovery were assessed.
  
  
  RESULTS
  The prevalence of baseline anemia was 49% (n = 124)--recovery from anemia occurred in 40% of the anemic patients (n = 49) at 1 year after TAVI with an increase in mean Hb-level of 1.35 g/dL from baseline. This increase was not related to an improvement in renal function. At multivariate analysis, a high peak gradient (OR 4.82, P = 0.003) was shown to be an independent predictor for Hb-recovery, while blood transfusion (OR 0.31, P = 0.038) and chronic kidney disease (CKD, OR 0.33, P = 0.043) were identified as negative predictors at, respectively, one and two years after TAVI. When compared to patients without baseline anemia, those anemic patients with Hb-recovery had a similar functional improvement (OR 0.98, P = 0.975), whereas those without Hb-recovery had a significantly lower likelihood of functional improvement with ≧2 NYHA classes (OR 0.49, P = 0.034) and a higher likelihood of re-hospitalization within the first year after TAVI (OR 1.91, P = 0.024).
  
  
  CONCLUSIONS
  Recovery from anemia occurs in 40% of anemic patients at 1 year after TAVI--mainly in those with a high gradient and without CKD. Blood transfusion was found to have a transient adverse effect on this Hb-recovery. Finally, anemic patients without Hb-recovery experience less functional improvement and have a higher re-hospitalization rate within the first year after TAVI.
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: De Backer
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Samer
authors.initials: S
authors.lastname: Arnous
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Lønborg
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Matthew
authors.initials: M
authors.lastname: Brooks
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Luigi
authors.initials: L
authors.lastname: Biasco
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Jönsson
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Olaf W
authors.initials: OW
authors.lastname: Franzen
authors.affiliation: Department of Cardiology, Rigshospitalet University Hospital, Copenhagen, Sjælland, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Søndergaard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D001024:Aortic Valve Stenosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D001803:Blood Transfusion; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D011379:Prognosis; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins