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Mironova A.I.

National Medical Research Center of Cardiology

Kropacheva E.S.

National Medical Research Center of Cardiology

Komlev A.E.

Chazov National Research Center of Cardiology

Imaev T.E.

Chazov National Research Center of Cardiology

Panchenko E.P.

National Medical Research Center of Cardiology

Predictors of in-hospital hemorrhagic complications in patients with atrial fibrillation undergoing transcatheter aortic valve implantation

Authors:

Mironova A.I., Kropacheva E.S., Komlev A.E., Imaev T.E., Panchenko E.P.

More about the authors

Journal: Russian Cardiology Bulletin. 2022;17(2): 65‑72

DOI: 10.17116/Cardiobulletin20221702165

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To cite this article:

Mironova AI, Kropacheva ES, Komlev AE, Imaev TE, Panchenko EP. Predictors of in-hospital hemorrhagic complications in patients with atrial fibrillation undergoing transcatheter aortic valve implantation. Russian Cardiology Bulletin. 2022;17(2):65‑72. (In Russ.)
https://doi.org/10.17116/Cardiobulletin20221702165

 
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OBJECTIVE

To analyze clinical predictors of in-hospital hemorrhagic complications in patients with atrial fibrillation undergoing transcatheter aortic valve implantation (TAVI).

MATERIAL AND METHODS

The study enrolled 100 patients (43 men) with atrial fibrillation undergoing TAVI. Median age was 79 years. Most patients had a high risk of thromboembolic complications (median CHA2DS2-VASc score 5).

RESULTS

Incidence of major in-hospital hemorrhagic complications was 14%. In most cases (64%), bleeding was associated with femoral artery puncture. Predictors of major in-hospital bleedings were routine «bridge therapy», female gender, hypoproteinemia upon admission and percutaneous coronary intervention within 3 months before TAVI.

CONCLUSION

Patients with atrial fibrillation and aortic stenosis have a high risk of thromboembolic complications and bleeding. Direct oral anticoagulation is associated with better safety profile compared to warfarin. However, in-hospital incidence of bleeding in patients with atrial fibrillation undergoing transcatheter aortic valve implantation is 7—14%. The factors reducing the risk of perioperative bleeding are refusal of bridge therapy and routine multicomponent antithrombotic therapy, with exception of patients with recent percutaneous coronary intervention, as well as the optimal timing of withdrawal of direct oral anticoagulation.

Keywords:

atrial fibrillation
anticoagulation
hemorrhagic complications
transcatheter aortic valve implantation

Authors:

Mironova A.I.

National Medical Research Center of Cardiology

Kropacheva E.S.

National Medical Research Center of Cardiology

Komlev A.E.

Chazov National Research Center of Cardiology

Imaev T.E.

Chazov National Research Center of Cardiology

Panchenko E.P.

National Medical Research Center of Cardiology

Received:

08.02.2022

Accepted:

18.03.2022

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