Abstract 12939: Platelet Activation is Less Enhanced in Edwards Sapien 3 Valve Compared to Its Precursor Model
Background: Due to a different design of the Cobalt chromium alloy frame and the additional outerskirt to minimize paravalvular leakage one might imagine that the extent of platelet activation (PA) of new Edwards Sapien 3 valve (ESV3) might differ from the Edward Sapien XT valve (ESVXT).
Aim of the study:
The aim of our study was to compare platelet aggregation (Agg) and platelet activation (PA) of the ESV-XT with the newer ESV-3 in pts undergoing TAVI on dual antiplatelet therapy .
Methods: Pts scheduled for TAVI were loaded with 600 mg Clp and 500 mg ASA the day before intervention.
Platelet Agg were evaluated in all pts by the Multiplate system (Dynabyte, Munich, Germany) before (T0), directly after intervention (T1) and on T2 (day1), T3 (day2) , T4 (day3) . PA was simultaneously assessed with the use of immunologic markers of PA as CD62P and PAC-1 by flow cytometry.
Results: 43 pts (age 81.3 +1.2 years ) with severe aortic stenosis and high surgical risk (log Euroscore 18.1 +1.3 %) underwent successfully TAVI with the ESV-XT and 29 pts (age 82.6 + 1.2 years, log Euroscore 21.5 +2.9 %) underwent TAVI with the ESV-3. .
Platelet Agg was inhibited to the same extent in both valve types directly after TAVI under dual antiplatelet therapy [ESV-XT (T1) versus ESV-3 3 (T1) : AggADP, (AUC): 16 (11-24) versus 16 (10-20); p=0.514; AggTRAP (AUC): 61(41-81) versus 69(52-79);p=0.244; AggASPI (AUC): 13(5-19) versus 11 (5-17); p=0.436. ] There was no significant difference in platelet drop between both valve types between day 0 and day3. [ESV-XT (T0T3) versus ESV-3 (T0T3): 55.2 ± 4.2 versus 63.5± 8.1; p=0.364. ]
However there was an enhanced expression of PA markers (CD62P and PAC-1) directly after implantation in pts with ESV-XT compared to pts with the ESV-3. [ESV-XT versus ESV-3 :median (25th;75th percentile) mean immunofluorescence : CD62P : 7.4 (6.8-8.6) versus 6.6 (6-7.9), p=0.014; PAC-1 : 4.2(3.6-4.7) versus 3.4 (3.2 -4.9), p=0.045.]
Conclusion: Our results show that dual antiplatelet therapy inhibits platelet Agg in both valve types to the same extent. However PA is less enhanced in pts with the ESV-3, than in pts the ESV-XT directly after implantation
Author Disclosures: S. Fateh-Moghadam: None. S. Voesch: None. M. Gawaz: None. W. bocksch: None.
- © 2014 by American Heart Association, Inc.