Associazione Nazionale Medici Cardiologi Ospedalieri



Transcatheter aortic valve replacement in patients with chronic thrombocytopenia: Prevalence and in-hospital outcomes

Zuin Marco Ferrara (Ferrara) – Dipartimento Di Medicina Trnaslazionale | Bilato Claudio Arzignano (Arzignano) – Ospedali Dell’Ovest Vicentino | Pasquetto Gianpaolo Schaivonia (Padova) – Ospedali Riuniti Padova Sud | Rigatelli Gianluca Schiavonia (Padova) – Ospedali Riuniti Padova Sud

Background: Thrombocytopenia represents an important issue in patients undergoing Transcatheter aortic valve replacement (TAVR) due to severe aortic stenosis. We performed a systematic review and meta-analysis to establish the pooled prevalence and the in-hospital outcomes of Chronic thrombocytopenia (cTCP) in patients after TAVR.

Methods: PubMed and Scopus databases were systematically searched for articles, published in any language, from inception through September 15, 2022, reporting the prevalence of cTCP in patients who underwent TAVR and providing data on the hospital outcomes. The pooled prevalence and the outcomes were evaluated pooling the adjusted odds ratio (OR) with the related 95% confidence interval (CI) using a random- effect models. Statistical heterogeneity between groups was measured using the Higgins I2 statistic

Results: Overall, 1,402,431 patients (mean age 87.2 years, 45.1% females) where hospitalized for TAVR. Among them, cTCP was observed in 7.0% of cases (95% CI: 1.7-24.5%, p<0.0001, I2:84.5%). No significant differences were observed for in-hospital mortality and stroke comparing patients with cTCP to those without (OR: 1.07, 95% CI: 0.62-1.82, p=0.802, I2: 79.6% and OR: 0.90, 95% CI: 0.67-1.21, p=0.48, I2: 0%, respectively). Conversely, cTCP subjects showed a significant higher risk of vascular complications (OR: 1.72, 95% ci 1.37-2.16, p<0.0001, I2:0%), acute kidney injury (OR: 1.60, 95% CI: 1.16-2.20, p=0.004, I2:81.4%) and cardiac tamponade (OR: 3.31, 95% ci: 1.85-5.94, p<0.0001, I2: 0%) (Figure 1).

Conclusions: cTCP is present in about 7% of patients underoing TAVR and was results associated with an increased risk of vascular complications and cardiac tamponade during the periprocedural period.