Preprocedural anemia in females undergoing transcatheter aortic valve implantation: Insights from the WIN-TAVI registry

Johny Nicolas, Bimmer E. Claessen, Davide Cao, Samantha Sartori, Usman Baber, David Power, Mauro Chiarito, Ridhima Goel, Anastasios Roumeliotis, Rishi Chandiramani, Siyan Chen, Jaya Chandrasekhar, Didier Tchetche, Anna Sonia Petronio, Julinda Mehilli, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Alessandro Iadanza, Gennaro SardellaNicolas M. Van Mieghem, Emanuele Meliga, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Maria Cruz Ferrer-Gracia, Christoph Naber, Samin Sharma, Marie Claude Morice, George D. Dangas, Alaide Chieffo, Roxana Mehran

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objectives: To assess the impact of anemia on clinical outcomes in female patients enrolled in the Women's InterNational transcatheter aortic valve implantation (WIN-TAVI) registry. Background: Anemia is highly prevalent among females who constitute half of TAVI candidates, yet, its clinical significance remains poorly investigated. Methods: Patients were divided into three groups according to preprocedural hemoglobin (Hb) level: (1) no anemia (Hb ≥12 g/dl), (2) mild-to-moderate anemia (10 ≤ Hb <12 g/dl), and (3) severe anemia (Hb <10 g/dl). The primary outcome was the occurrence of Valve Academic Research Consortium (VARC)-2 efficacy endpoint, a composite of mortality, stroke, myocardial infarction (MI), hospitalization for valve-related symptoms or heart failure or valve-related dysfunction at 1-year follow-up. Results: Hemoglobin level was available in 877 (86.1%) patients: 412 (47.0%) had no anemia, 363 (41.4%) had mild-to-moderate anemia, and 102 (11.6%) had severe anemia. The latter group had a higher prevalence of cardiovascular risk factors. Compared with patients without anemia, severe anemia was associated with a greater risk of VARC-2 efficacy endpoint (adjHR 1.71, 95% CI: 1.02–2.87, p =.04), all-cause death (adjHR 2.36, 95% CI: 1.31–4.26, p =.004) and a composite of death, MI or stroke (adjHR 1.88, 95% CI: 1.10–3.22, p =.02) at 1 year. Moreover, an increased risk of late mortality (adjHR 1.15, 95% CI: 1.02–1.30, p =.03) was observed with every 1 g/dl decrease in hemoglobin level. Conclusion: Severe anemia in females undergoing TAVI was independently associated with increased rates of VARC-2 efficacy endpoint and mortality at 1 year.

Original languageEnglish
Pages (from-to)E704-E715
JournalCatheterization and Cardiovascular Interventions
Issue number5
StatePublished - 1 Apr 2021


  • TAVI
  • TAVR
  • anemia
  • female


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