title: Platelet activation is less enhanced in the new balloon expandable Edwards Sapien 3 valve compared to its predecessor model (Edwards Sapien XT).
abstract: Stroke and thromboembolic events after transfemoral aortic valve replacement (TAVR) continue to be a problem. The aim of our study was to compare platelet aggregation (Agg) and platelet activation (PA) observed with two different catheter valves, the ESV-XT and the newer ESV-3 valve in patients (pts) undergoing TAVR on dual antiplatelet therapy (DAPT). A total of 174 patients with severe aortic stenosis and high surgical risk successfully underwent TAVR (60 ESV-XT; 114 ESV-3). Platelet Agg and PA (CD62P expression) were evaluated before and the following three days after TAVR under DAPT. Platelet Agg was inhibited to the same extent in both valve types and there was no significant difference in platelet drop between both valve types between day 0 and day 3 [ESV-XT vs ESV-3: median (25th-75th percentile): platelet count (x1000): 55 (42-74) vs 61(42-93), p=0.280]. However, there was an enhanced CD62P expression directly after TAVR with the ESV-XT compared to the ESV-3 [CD62P (MIF): 7.4 (6.8-8.6) vs 6.6 (6-7.9), p=0.014]. Surface expression of platelet CD62P was associated with the occurrence of residual aortic regurgitation (AR) and was significantly higher in patients with residual AR [CD62P (mild AR) vs CD 62P (no or trace AR): 7.9 (7.3-9.1) vs 7.1 (6.4-8.0), p < 0.001)]. PA was significantly enhanced in patients with the ESV-XT compared to the ESV-3 valve and was associated with the amount of residual AR which was significantly reduced by ESV-3. This may have implications for thromboembolic events following TAVR procedure.
authors: Suzanne Fateh-Moghadam, Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Universitaetsklinikum Tuebingen, Otfried-Mueller-Straße 10, D-72076 Tuebingen, Germany, Tel.: +49 7071 804090, Fax: +49 7071 295413, E-mail: suzanne.fateh-moghadam@med.uni-tuebingen.de.
authors: Suzanne
authors: S
authors: Fateh-Moghadam
authors: Sabrina
authors: S
authors: Voesch
authors: Patrik
authors: P
authors: Htun
authors: Rezo
authors: R
authors: Jorbenadze
authors: Tobias
authors: T
authors: Geisler
authors: Meinrad
authors: M
authors: Gawaz
authors: Wolfgang
authors: W
authors: Bocksch
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D001024:Aortic Valve Stenosis / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D063126:Balloon Valvuloplasty; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D019007:P-Selectin / Q000097:blood; D015539:Platelet Activation / Q000187:drug effects; D010974:Platelet Aggregation; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010976:Platelet Count; D010979:Platelet Function Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019007:P-Selectin; D010975:Platelet Aggregation Inhibitors; C546937:SELP protein, human
keywords: DAPT; Edwards Sapien 3 valve; Edwards Sapien XT; Platelet activation; TAVR; residual aortic regurgitation