Title :

Paradoxical Increase of Stroke in Patients with Defect of High Molecular Weight Multimers of the von Willebrand Factors following Transcatheter Aortic Valve Replacement

Author(s) :

Matsushita, Kensuke [Auteur]
Nanomédecine Régénérative [NanoRegMed]
Marchandot, Benjamin [Auteur]
Nouvel Hôpital Civil de Strasbourg
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Trimaille, Antonin [Auteur]
Nanomédecine Régénérative [NanoRegMed]
Kibler, Marion [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Heger, Joe [Auteur]
Nouvel Hôpital Civil de Strasbourg
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Université de Strasbourg [UNISTRA]
Peillex, Marilou [Auteur]
Nouvel Hôpital Civil de Strasbourg
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Université de Strasbourg [UNISTRA]
Hess, Sebastien [Auteur]
Nouvel Hôpital Civil de Strasbourg
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Université de Strasbourg [UNISTRA]
Grunebaum, Lelia [Auteur]
Reydel, Antje [Auteur]
Université de Strasbourg [UNISTRA]
Nouvel Hôpital Civil de Strasbourg
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Kindo, Michel [Auteur]
Les Hôpitaux Universitaires de Strasbourg [HUS]
Hoang, Minh Tam [Auteur]
Laboratoire de Génie Civil et d'Ingénierie Environnementale [LGCIE]
Sato, Chisato [Auteur]
Nanomédecine Régénérative [NanoRegMed]
de Poli, Fabien [Auteur]
Leddet, Pierre [Auteur]
Centre hospitalier de Haguenau
Ohana, Mickael [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Jesel, Laurence [Auteur]
Nanomédecine Régénérative [NanoRegMed]
Ohlmann, Patrick [Auteur]
Nanomédecine Régénérative [NanoRegMed]
Susen, Sophie [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Morel, Olivier [Auteur]
Nanomédecine Régénérative [NanoRegMed]

Journal title :

Thrombosis and haemostasis

Pages :

1330-1338

Publisher :

Schattauer

Publication date :

2020-07-29

ISSN :

0340-6245

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Abstract Background Stroke is a major cause of disability after transcatheter aortic valve replacement (TAVR) and stroke prediction models and data are crucially needed. Following TAVR, high molecular weight (HMW) multimers ...
Show more >Abstract Background Stroke is a major cause of disability after transcatheter aortic valve replacement (TAVR) and stroke prediction models and data are crucially needed. Following TAVR, high molecular weight (HMW) multimers defect of von Willebrand factor (VWF) as assessed by closure time of adenosine diphosphate (CT-ADP) value > 180 seconds is an independent predictor of bleeding events. This study sought to identify predictors of ischemic neurological events in patients who underwent TAVR and the specific impact of HMW multimers defect of VWF. Methods Patients were prospectively enrolled between November 2012 and May 2018 at our institution. The CT-ADP, a point-of-care measure of hemostasis, was assessed the day before and 24 hours after the procedures. The rate of ischemic stroke and transient ischemic attack (TIA) was recorded up to 30 days after the procedures. Results Of 565 TAVR patients, ischemic stroke/TIA was observed in 21 (3.7%) patients within 30 days. Ischemic stroke/TIA was associated with major/life-threatening bleeding complications (MLBCs) (9 [43%] vs. 88 [16%], p = 0.002) and postprocedure CT-ADP > 180 seconds (10 [48%] vs. 116 [21%], p = 0.01). By multivariate analysis, MLBCs (odds ratio [OR]: 3.58; 95% confidence interval [CI]: 1.45–8.84; p = 0.006) and postprocedure CT-ADP > 180 seconds (OR: 3.38; 95% CI: 1.38–8.25; p = 0.008) were evidenced as independent predictors of ischemic stroke/TIA. Conclusion MLBCs and CT-ADP > 180 seconds were identified as predictors for ischemic stroke or TIA. The present study suggests that the defects of HMW multimers of the VWFs may contribute not only to bleeding events but also to thrombotic events.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011

Source :

Harvested from HAL