Thrombocytopenia Following Trans-Catheter Aortic Valve Implantation: Predictors    and Clinical Impact

Andaleeb Khan; Muhammad Nadir   Khan; Waheed  ur Rehman; Ali    Muhammad; Adeel   Ahmed; Gulzar Ali

doi:10.51253/pafmj.v76iSUPPL-4.14175

Authors

Andaleeb Khan Department of Adult Cardiology, Armed Forces Institute of Cardiology, Rawalpindi/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Pakistan
Muhammad Nadir Khan Department of Adult Cardiology, Armed Forces Institute of Cardiology, Rawalpindi/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Pakistan
Waheed ur Rehman Department of Adult Cardiology, Armed Forces Institute of Cardiology, Rawalpindi/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Pakistan
Ali Muhammad Department of Adult Cardiology, Armed Forces Institute of Cardiology, Rawalpindi/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Pakistan
Adeel Ahmed Department of Adult Cardiology, Armed Forces Institute of Cardiology, Rawalpindi/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Pakistan
Gulzar Ali Department of Adult Cardiology, Armed Forces Institute of Cardiology, Rawalpindi/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-4.14175

Keywords:

Aortic valve stenosis, Platelet count, Predictors, Thrombocytopenia, Transcatheter aortic valve implantation

Abstract

Objective: To identify the factors associated with thrombocytopenia and to evaluate its clinical consequences among patients undergoing transcatheter aortic valve implantation (TAVI) at a tertiary cardiac care facility in Pakistan.

Study Design: longitudinal study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, Pakistan; from March 2015 to September 2025.

Methodology: A total of 66 patients were included in the study. Patients aged ≥65 years with baseline platelet counts ≥100×10⁹/L were included. Thrombocytopenia was defined as ≥50% fall from baseline or platelet count <150×10⁹/L within 72 hours post-procedure. Patients with pre-existing thrombocytopenia <100 x10 µ/L or conditions that could affect platelet count, such as hematological disorders were excluded. Outcomes included thrombocytopenia, bleeding, acute kidney injury (AKI), vascular complications, hospital stay, and in-hospital mortality.

Results: Among 66 patients with a mean age of 73.00(69.75-78.00) years, 50(75.8%) were male, and thrombocytopenia occurred in 56 (84.8%) cases. Hemoglobin levels [aOR 3.36 (1.13–9.98) p=0.02], valve size [aOR 0.62 (0.38–1.01) p=0.05] and coronary artery disease [aOR 0.04 (0.001–1.11) p=0.05] were independently associated with the development of thrombocytopenia. This was significantly associated with AKI (p=0.01) and longer hospital stay (p=0.04) but showed no association with mortality or bleeding. Conclusion: Thrombocytopenia is a frequent post-TAVI finding, associated with AKI and prolonged hospitalization. Optimization of modifiable factors such as low hemoglobin, valve size and coronary artery disease may mitigate adverse outcomes.

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