Abstract 4366920: A Remedy for the Heart and the Hemoglobin: Improvement in Anemia Post Transcatheter Aortic Valve Replacement
Abstract
Background: Aortic stenosis (AS) affects nearly 0.4% of the US population. Among this cohort, anemia is a significant comorbidity, affecting 30-45% of patients. This is thought to occur via gastrointestinal losses through the mechanism of angiodysplasia and progressive renal disease and is associated with worse symptoms and outcomes. Transcatheter aortic valve replacement (TAVR) tends to improve anemia post-procedure, but further investigation to determine the significance and potential contributing variables is needed. Methods: We performed a retrospective chart review of patients undergoing TAVR at the University of Illinois Hospital and Jesse Brown Veterans Association from 2018 to 2024. Anemia was defined as hemoglobin (Hgb) <12g/dL for females and <13g/dL for males. Renal function was determined by serum creatinine and by glomerular filtration rate (GFR, categorized into stages, >90, 60-89, 30-59, 15-29, <15). Demographic data and interval Hgb levels at 0-,6-,and 12-months post-TAVR were compared using SPSS. Subgroup analysis for change in Hgb was completed for baseline GFR, anticoagulant/antiplatelet (AC/AP) use, comorbidities including hypertension, diabetes, peripheral arterial disease, history of prior cerebrovascular accidents and history of prior major bleeds. Chi-square, paired t-test and linear regressions were used to analyze the data as appropriate. Results: 345 patients were included in the study, 245 (71%) were male, average age was 76.3, baseline average Hgb was 11.4 g/dL (74.6% anemic), and 165 had baseline reduced renal function (GFR <60, 47.8%). Average Hgb was significantly increased at 12 months for all patients (11.9 from 11.4 g/dL, p = 0.007), and rates of anemia were significantly reduced at 6 months and 12 months compared to baseline (66.0% and 62.6% respectively, p=0.0318, p=0.0087 respectively). Subgroup multivariable analysis showed no statistically significant predictor of change in Hgb. Additionally, there was no significant change in renal function at either 6 months or 12 months compared to baseline. Conclusion: Increase in Hgb and decrease in anemia prevalence post TAVR with no change in renal function suggests that TAVR itself has benefits in the management of anemia in patients with AS through a mechanism independent of anemia associated with renal disease. Moreover, no baseline patient characteristics predicted this change, reiterating that correction of aortic stenosis is the likely primary driver of change.
Article Details
Authors (40)
Raghav Matta
University of Illinois Chicago, Chicago, Illinois, United States
Omar Uraizee
University of Illinois Chicago, Chicago, Illinois, United States
Suhas Seshadri
University of Illinois-Chicago, Chicago, Illinois, United States
Andrew Carlson
University of Illinois Chicago, Chicago, Illinois, United States
Siddharth Bhayani
University of Illinois Chicago, Chicago, Illinois, United States
Azmer Khan
University of Illinois Chicago, Chicago, Illinois, United States
Rohan Bhattaram
University of Illinois Chicago, Chicago, Illinois, United States
Runze Zhang
Drug Discovery and Design Center, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences
Pal Shah
University of Illinois Chicago, Chicago, Illinois, United States
Aanya Roy
University of Illinois Chicago, Chicago, Illinois, United States
Bayan Hammad
University of Illinois Chicago, Chicago, Illinois, United States
Arvind Draffen
University of Illinois Chicago, Chicago, Illinois, United States
Zachary Natsheh
University of Illinois Chicago, Chicago, Illinois, United States
Daniel Tiu
University of Illinois Chicago, Plainfield, Illinois, United States
David Tiu
University of Illinois Chicago, Plainfield, Illinois, United States
Edward Salem
University of Illinois Chicago, Chicago , Illinois, United States
Jesse Balami
University of Illinois Chicago, Chicago, Illinois, United States
Swetha Kalagara
University of Illinois Chicago, Chicago, Illinois, United States
Neil Gupta
University of Illinois Chicago, Chicago , Illinois, United States
Savina Sahgal
University of Illinois Chicago, Plainfield, Illinois, United States
Atreya Mishra
University of Illinois Chicago, Plainfield, Illinois, United States
Adriana Ene
University of Illinois Chicago, Chicago, Illinois, United States
Aleyah Hattab
University of Illinois Chicago, Plainfield, Illinois, United States
Aarushi Arora
University of Illinois Chicago, Chicago, Illinois, United States
Humam Sufyaan
University of Illinois Chicago, Chicago, Illinois, United States
Trang Dau
University of Illinois Chicago, Plainfield, Illinois, United States
Jonathan Silberstein
University of Illinois Chicago, Chicago, Illinois, United States
Julia Yu
University of Illinois Chicago, Chicago, Illinois, United States
Kayla Torres
University of Illinois Chicago, Chicago, Illinois, United States
Laura Navarro
University of Illinois Chicago, Plainfield, Illinois, United States
Manisha Singam
University of Illinois Chicago, Plainfield, Illinois, United States
Mariam Ismail
Department of Chemistry, Hunter College
Riya Rana
University of Illinois Chicago, Chicago, Illinois, United States
Samer Habeel
University of Connecticut, Farmington, Connecticut, United States
Simon Liu
University of Illinois Chicago, Chicago, Illinois, United States
Srinidhi Chaganti
University of Illinois Chicago, Chicago, Illinois, United States
Vidur Gurbuxani
University of Illinois Chicago, Chicago, Illinois, United States
Stephanie Dwyer Kaluzna
University of Illinois Chicago, Chicago, Illinois, United States
Vicki Groo
University of Illinois Chicago, Plainfield, Illinois, United States
Adhir Shroff
University of Illinois Chicago, Plainfield, Illinois, United States