Anna Komosa1, Bartłomiej Perek2, Piotr Rzymski3,4, Barbara Poniedziałek3, Marek Grygier5, Andrzej Siniawski5, Katarzyna Szabatowska5, Jolanta Siller-Matula6,7, Marek Jemielity2, Marcin Misterski2, Maciej Lesiak5. 1. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland. komosa.ania@ump.edu.pl. 2. Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland. 3. Department of Facial Malformation, Poznan University of Medical Sciences, Poznań, Poland. 4. Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), Poznań, Poland. 5. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland. 6. Department of Cardiology, Medical University of Vienna, Vienna, Austria. 7. Department of Experimental and Clinical Pharmacology, Center for Preclinical Research and Technology CEPT, Medical University of Warsaw, Warszawa, Poland.
Abstract
BACKGROUND: Intervention-induced platelet hypercoagulability may pose a risk of serious adverse events for patients. AIMS: This study aimed to assess whether surgical and transcatheter aortic valve replacement (SAVR and TAVR) differ in periprocedural platelet activity. METHODS: The total number of 24 patients with a mean age (SD) of 71 (13) years who underwent SAVR (n = 12) or TAVR (n = 12) were recruited for the study. The following parameters were evaluated at 4 time-points: (i) platelet indices: total platelet count (PLT), platelet distribution width (PDW) and mean platelet volume (MPV), (ii) MPV/PLT ratio, (iii) platelet level of lipid peroxidation: malondialdehyde (MDA) content and MDA/PLT ratio. Eventually, percentage variations of PLT, PDW, and MPV in relation to the baseline values were determined. RESULTS: MPV/PLT ratio increased significantly after procedures in both groups (P = 0.01 in TAVI and P = 0.01 in SAVR). MDA concentrations were significantly higher when assessed directly post-procedure (P = 0.04) as well as 24 hours later (P = 0.01) in the SAVR and TAVI groups. The indirect parameter of platelet activity indexed for platelet counts (MDA/PLT) was comparable between both groups before and 48 hours after procedures, but was significantly higher in SAVR patients, particularly after 24 hours after interventions (P = 0.04; medians TAVR vs SAVR, respectively). CONCLUSIONS: Standard surgical aortic valve replacement is associated with a more pronounced platelet reaction to intervention-induced injury, as compared to the transcatheter-based procedure. The importance of these laboratory findings requires further investigation focused on early and late clinical outcomes.
BACKGROUND: Intervention-induced platelet hypercoagulability may pose a risk of serious adverse events for patients. AIMS: This study aimed to assess whether surgical and transcatheter aortic valve replacement (SAVR and TAVR) differ in periprocedural platelet activity. METHODS: The total number of 24 patients with a mean age (SD) of 71 (13) years who underwent SAVR (n = 12) or TAVR (n = 12) were recruited for the study. The following parameters were evaluated at 4 time-points: (i) platelet indices: total platelet count (PLT), platelet distribution width (PDW) and mean platelet volume (MPV), (ii) MPV/PLT ratio, (iii) platelet level of lipid peroxidation: malondialdehyde (MDA) content and MDA/PLT ratio. Eventually, percentage variations of PLT, PDW, and MPV in relation to the baseline values were determined. RESULTS: MPV/PLT ratio increased significantly after procedures in both groups (P = 0.01 in TAVI and P = 0.01 in SAVR). MDA concentrations were significantly higher when assessed directly post-procedure (P = 0.04) as well as 24 hours later (P = 0.01) in the SAVR and TAVI groups. The indirect parameter of platelet activity indexed for platelet counts (MDA/PLT) was comparable between both groups before and 48 hours after procedures, but was significantly higher in SAVR patients, particularly after 24 hours after interventions (P = 0.04; medians TAVR vs SAVR, respectively). CONCLUSIONS: Standard surgical aortic valve replacement is associated with a more pronounced platelet reaction to intervention-induced injury, as compared to the transcatheter-based procedure. The importance of these laboratory findings requires further investigation focused on early and late clinical outcomes.
Authors: Konrad Stelmark; Eli Adrian Zaher; Anna Olasińska-Wiśniewska; Michael Adesina; Alicia Dragone; Martha Isaac; Marcin Misterski; Marek Grygier; Mateusz Puślecki; Maciej Lesiak; Marek Jemielity; Bartłomiej Perek Journal: Kardiochir Torakochirurgia Pol Date: 2021-10-05