Abstract 4366920: A Remedy for the Heart and the Hemoglobin: Improvement in Anemia Post Transcatheter Aortic Valve Replacement

Background: Aortic stenosis (AS) affects nearly 0.4% of the US population. Among this cohort, anemia is a significant comorbidity, affecting 30-45% of patients. This is thought to occur via gastrointestinal losses through the mechanism of angiodysplasia and progressive renal disease and is associated with worse symptoms and outcomes. Transcatheter aortic valve replacement (TAVR) tends to improve anemia post-procedure, but further investigation to determine the significance and potential contributing variables is needed. Methods: We performed a retrospective chart review of patients undergoing TAVR at the University of Illinois Hospital and Jesse Brown Veterans Association from 2018 to 2024. Anemia was defined as hemoglobin (Hgb) <12g/dL for females and <13g/dL for males. Renal function was determined by serum creatinine and by glomerular filtration rate (GFR, categorized into stages, >90, 60-89, 30-59, 15-29, <15). Demographic data and interval Hgb levels at 0-,6-,and 12-months post-TAVR were compared using SPSS. Subgroup analysis for change in Hgb was completed for baseline GFR, anticoagulant/antiplatelet (AC/AP) use, comorbidities including hypertension, diabetes, peripheral arterial disease, history of prior cerebrovascular accidents and history of prior major bleeds. Chi-square, paired t-test and linear regressions were used to analyze the data as appropriate. Results: 345 patients were included in the study, 245 (71%) were male, average age was 76.3, baseline average Hgb was 11.4 g/dL (74.6% anemic), and 165 had baseline reduced renal function (GFR <60, 47.8%). Average Hgb was significantly increased at 12 months for all patients (11.9 from 11.4 g/dL, p = 0.007), and rates of anemia were significantly reduced at 6 months and 12 months compared to baseline (66.0% and 62.6% respectively, p=0.0318, p=0.0087 respectively). Subgroup multivariable analysis showed no statistically significant predictor of change in Hgb. Additionally, there was no significant change in renal function at either 6 months or 12 months compared to baseline. Conclusion: Increase in Hgb and decrease in anemia prevalence post TAVR with no change in renal function suggests that TAVR itself has benefits in the management of anemia in patients with AS through a mechanism independent of anemia associated with renal disease. Moreover, no baseline patient characteristics predicted this change, reiterating that correction of aortic stenosis is the likely primary driver of change.