There is strong evidence of the prognostic value of GLS, which appears to have superior prognostic value to EF for predicting major adverse cardiac events.
Background: The Crusade Bleeding Score (CBS) is predictive of in hospital major bleeding in acute coronary syndrome (ACS) patients, however its utility in other syndromes is unknown. We sought to investigate the relationship between the CBS and bleeding in Trans Catheter Aortic Valve Replacement (TAVR) patients.Methods: A retrospective analysis of our TAVR registry was performed focusing on bleeding as defined by the VARC criteria.
As part of this, preoperative and discharge haemoglobin (Hb) values were collected as well as the number of units of packed red blood cells (PRBC) transfused. Each patient had their CBS calculated. Simple change in Hb (SCHB) was defined as preoperative Hb minus discharge Hb. Absolute change in Hb (ACHB) was defined as SCHB + 10× number of PRBC units received during their admission. A pairwise correlation test was then performed to determine if a correlation existed between CBS and SCHB or ACHB.Results: 105 patients were included from 25/8/2008 to 20/9/2011. Mean Hb over the admission decreased from 121.2 ± 16.9 to 105 ± 13.7 g/dL (p < 0.0001). Mean CBS was 39.2 ± 12.1. Mean SCHB was 15.6 ± 13.7 and mean ACHB was 22.4 ± 13.7 g/dL. There was a counter-intuitive negative weak correlation between SCHB and CS ( Fig. 1: correlation coefficient −0.25, p = 0.01) but no correlation between ACHB and CS (Fig. 2: correlation coefficient −0.03, p = 0.75).Conclusion: Unlike in ACS patients, the crusade bleeding score is not a useful clinical risk stratification tool for bleeding in TAVR patients.
ABSTRACTS
Heart, Lung and CirculationAbstracts S163 2012;21:S143-S316 CSANZ 2012 Abstracts BMS ≥ 3 mm in diameter and all long DES (small and large diameters) however had satisfactory outcomes comparable to short stents.http://dx.
S339 these agents on plaque composition remains poorly characterised. Frequency-optical coherence tomography (FD-OCT) permits visualisation of plaque microstructures in vivo. The current study compared FD-OCT derived plaque microstructures in patients treated with high-dose rosuvastatin and atorvastatin. Methods: 117 non-culprit lipid plaques in 134 patients with coronary artery disease, undergoing percutaneous coronary intervention, who received high-dose rosuvastatin (mean dose 21.5 mg) or atorvastatin (mean dose 68.7 mg) were characterized by FD-OCT. Clinical demographics and FD-OCT derived plaque microstructures were compared. Results: Rosuvastatin-treated patients were more likely to be obese (BMI; 34.4 vs. 29.5 kg/m 2 , p=0.003), have hypertension (69 vs. 38%, p=0.03) and metabolic syndrome (91.6 vs. 48.2%, p-0.004) and had a trend to lower levels of low-density lipoprotein cholesterol (1.9±0.4 vs. 2.4±0.9 mmol/l, p=0.09). FD-OCT imaging revealed that non-culprit lipid plaques in rosuvastatin-treated patients were less likely to harbor microchannels (7 vs. 46%, p=0.02) and had a smaller maximum arc of lipid (163±109 vs. 211±95 • , p=0.08), although this just failed to meet statistical significance. Fibrous cap thickness did not differ between the groups (124±73 vs. 109±71m, p=0.49). Following adjustment for clinical demographics, rosuvastatin use continued to associate with a lower prevalence of microchannels (p=0.03). Conclusions: Individual high-intensity statins may have differing effects on plaque microstructures at non-culprit lesions on FD-OCT imaging. Whether this translates to a more favourable effect on clinical events remains to be determined.
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