PDF(Pubmed)
Abstract：
UNASSIGNED: Data regarding the incidence, predictive factors, and clinical outcomes of post-transcatheter aortic valve replacement (TAVR) bleeding is limited in the Asian cohort.
UNASSIGNED: This study sought to assess the predictors and prognostic impact of post-TAVR late bleeding.
UNASSIGNED: This study used the Japanese multicenter registry data to analyze 2,518 patients (mean age: 84.3 ± 5.2 years) who underwent TAVR. Late bleeding was defined as any postdischarge bleeding events after TAVR. Baseline characteristics, predictive factors, and clinical outcomes including death and rehospitalization were assessed in patients with and without late bleeding events.
UNASSIGNED: The cumulative incidence rate of all and major late bleeding and ischemic stroke were 7.4%, 5.2%, and 3.4%, respectively, 3 years after TAVR. The independent predictive factors of late bleeding were low platelet count, high score (≥4) on the clinical frailty scale, and a New York Heart Association functional class III/IV. The cumulative mortality rates up to 3 years were significantly higher in patients with late bleeding than in those without bleeding (P < 0.001). The multivariate Cox regression analysis revealed that late bleeding, included as a time-varying covariate in the model, was associated with an increased risk of mortality following TAVR (HR: 5.63; 95% CI: 4.28-7.41; P < 0.001).
UNASSIGNED: Late bleeding after TAVR was not a rare complication, and it significantly increased long-term mortality. It should be carefully managed, especially when it is predictable in the high-risk cohort, and efforts should be taken to reduce bleeding complications even after a successful procedure.
UNASSIGNED: This study sought to assess the predictors and prognostic impact of post-TAVR late bleeding.
UNASSIGNED: This study used the Japanese multicenter registry data to analyze 2,518 patients (mean age: 84.3 ± 5.2 years) who underwent TAVR. Late bleeding was defined as any postdischarge bleeding events after TAVR. Baseline characteristics, predictive factors, and clinical outcomes including death and rehospitalization were assessed in patients with and without late bleeding events.
UNASSIGNED: The cumulative incidence rate of all and major late bleeding and ischemic stroke were 7.4%, 5.2%, and 3.4%, respectively, 3 years after TAVR. The independent predictive factors of late bleeding were low platelet count, high score (≥4) on the clinical frailty scale, and a New York Heart Association functional class III/IV. The cumulative mortality rates up to 3 years were significantly higher in patients with late bleeding than in those without bleeding (P < 0.001). The multivariate Cox regression analysis revealed that late bleeding, included as a time-varying covariate in the model, was associated with an increased risk of mortality following TAVR (HR: 5.63; 95% CI: 4.28-7.41; P < 0.001).
UNASSIGNED: Late bleeding after TAVR was not a rare complication, and it significantly increased long-term mortality. It should be carefully managed, especially when it is predictable in the high-risk cohort, and efforts should be taken to reduce bleeding complications even after a successful procedure.
摘要：
未经评估：有关发病率的数据，预测因素，在亚洲队列中,经导管主动脉瓣置换术(TAVR)后出血的临床结局有限.
UNASSIGNED：本研究旨在评估TAVR术后晚期出血的预测因子和预后影响。
UNASSIGNED：本研究使用日本多中心注册数据分析了2,518例接受TAVR的患者（平均年龄：84.3±5.2岁）。晚期出血定义为TAVR后任何出院后出血事件。基线特征，预测因素，对有或无晚期出血事件的患者进行临床结局评估,包括死亡和再住院.
UNASSIGNED：所有和严重晚期出血和缺血性卒中的累积发生率为7.4％，5.2%,和3.4%，分别,TAVR后3年。晚期出血的独立预测因素为低血小板计数,临床虚弱量表得分高（≥4），和纽约心脏协会功能等级III/IV。晚期出血患者3年的累积死亡率明显高于无出血患者(P<0.001)。多因素Cox回归分析显示，晚期出血，作为时变协变量包含在模型中，与TAVR后死亡风险增加相关(HR:5.63;95%CI:4.28-7.41;P<0.001)。
未经证实：TAVR术后迟发性出血并非罕见并发症，它显著增加了长期死亡率。应该小心管理，特别是当它在高风险人群中是可以预测的时候，即使手术成功，也应努力减少出血并发症。
UNASSIGNED：本研究旨在评估TAVR术后晚期出血的预测因子和预后影响。
UNASSIGNED：本研究使用日本多中心注册数据分析了2,518例接受TAVR的患者（平均年龄：84.3±5.2岁）。晚期出血定义为TAVR后任何出院后出血事件。基线特征，预测因素，对有或无晚期出血事件的患者进行临床结局评估,包括死亡和再住院.
UNASSIGNED：所有和严重晚期出血和缺血性卒中的累积发生率为7.4％，5.2%,和3.4%，分别,TAVR后3年。晚期出血的独立预测因素为低血小板计数,临床虚弱量表得分高（≥4），和纽约心脏协会功能等级III/IV。晚期出血患者3年的累积死亡率明显高于无出血患者(P<0.001)。多因素Cox回归分析显示，晚期出血，作为时变协变量包含在模型中，与TAVR后死亡风险增加相关(HR:5.63;95%CI:4.28-7.41;P<0.001)。
未经证实：TAVR术后迟发性出血并非罕见并发症，它显著增加了长期死亡率。应该小心管理，特别是当它在高风险人群中是可以预测的时候，即使手术成功，也应努力减少出血并发症。
