In the Hong Kong population, use of gastroprotective agents was associated with a reduced risk of GIB in patients taking dabigatran. The association was stronger for upper GIB than lower GIB, and in patients with a prior history of peptic ulcers or GIB.

Reported cases of coronary obstruction after TAVI occurred more frequently in women, in patients receiving a balloon-expandable valve, and the LCA was the most commonly involved artery. Percutaneous coronary intervention was a feasible and successful treatment in most cases. Continuous efforts should be made to identify the factors associated with this life-threatening complication to implement the appropriate measures for its prevention.

BPD was needed in about one-fourth of the patients undergoing TAVI with a balloon-expandable valve and was successful in about one-half of them. A higher degree of valve calcification and transfemoral approach predicted the need for BPD. BPD was not associated with any deleterious effect on valve function at mid-term follow-up, but a higher rate of cerebrovascular events was observed in patients who had BPD.

Up to 30% of patients with no prior conduction disturbances developed new LBBB following TAVI with a balloon-expandable valve, although it was transient in more than one third. Longer baseline QRS duration and a more ventricular positioning of the prosthesis were associated with a higher rate of persistent LBBB, which in turn determined higher risks for complete AVB and PPI, but not mortality, at 1-year follow-up.

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prognostic value for 1-year mortality independently of successful TAVR (pϭ0.024 and pϭ0.012 respectively). Conclusions: Thus pre-and postinterventional hscTnT levels demonstrate preserved longterm prognostic value in patients with severe aortic stenosis and may reflect a mortality risk independently of successful TAVR.Background: Chronic obstructive pulmonary disease (COPD) has been associated with higher mortality following transcatheter aortic valve implantation (TAVI), but no data exist on the factors determining poorer outcomes and functional status improvement in these patients. Methods: A total of 210 consecutive patients (29.5% COPD) who underwent TAVI were studied. Baseline, procedural characteristics and follow-up (median of 12 [6-24] months) data were prospectively collected. Functional status, as evaluated by NYHA class, Duke Activity Status Index (DASI) and 6-minute walking test (6MWT), were performed at baseline and at 6-12 months. Results: COPD patients were younger, more frequently male and had a history of smoking, peripheral vascular disease and diabetes mellitus. Survival rates at 1 year after TAVI were 66% in COPD versus 85% in no-COPD patients (pϭ0.002). In multivariate analysis, COPD was an independent predictor of cumulative mortality following TAVI [HR: 2.49, 95% CI: 1.38-4.48, pϭ0.003]. Among COPD patients, a shorter distance in the pre-procedure 6MWT predicted cumulative mortality [HR: 1.25 for each decrease of 20 m, 95% CI: 1.05-1.49, pϭ0.014], whereas poorer baseline spirometry results (FEV1) determined a higher rate of periprocedural pulmonary complications [OR: 1.44 for each decrease of 5%, 95% CI: 1.03-2.0, pϭ0.031]. Baseline FEV1 Ͻ60% of predicted and a distance Ͻ150 m in the 6MWT best determined the occurrence of periprocedural pulmonary complications and midterm mortality, respectively. A significant improvement in functional status was observed following TAVI (pϽ0.001 for changes in NYHA class, DASI and 6MWT), without differences in the degree of functional improvement between COPD and no-COPD patients (pϭNS between groups for changes in NYHA, DASI and 6MWT). Conclusions: COPD was associated with a higher rate of mortality at midterm follow-up. Among COPD patients, a higher degree of airway obstruction and a lower exercise capacity determined a higher risk for pulmonary complications and mortality, respectively. In addition, COPD patients who survived after TAVI exhibited similar improvements in functional status as the rest of the study population.Background: Prosthesis patient mismatch (PPM) is an independent predictor of mortality post aortic valve replacement. We sought to determine if 3-dimensional aortic annular measurements by multi-detector computed tomography (MDCT) are predictive of PPM post transcatheter aortic valve replacement (TAVR). Methods: 128 patients underwent MDCT then TAVR. Moderate PPM was defined as an indexed effective orifice area 0.85 cm2/m2 and severe 0.65 cm2/m2. MDCT annular measurements (area, short and long axis) were compared with the size of the s...

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Initiation of high-intensity statins is uncommon in Hong Kong. • Patients aged 70-84 had the highest annual statin initiation rates.