| Objectives:To examine the changes of routine blood test indices after transcatheter aortic valve implantation(TAVI),and explore the possible causes and significance of these changes.Methods:Analyzed retrospectively the clinical data of patients who received TAVI from March 2016 to November 2019 in the second affiliated Hospital of Nanchang University.According to the time,the patients were divided into three groups:the group without antithrombotic drugs before operation,the group with antithrombotic drugs before operation and the group after operation.then according to the difference of antithrombotic strategy,these patients were divided into antiplatelet group and anticoagulant group.The baseline data,operation related data,medical report,platelet count(PC),mean platelet volume(MPV),platelet distribution width(PDW),platelet crit(PCT),red cell distribution width(RDW),mean platelet volume/platelet count(MPR),red blood cell distribution width/platelet count(RPR)were recorded before and after TAVI.Results:23 patients were enrolled,the average age of the patients was 73.2±8.6 years old,13 males.18 patients were treated with dual antiplatelet therapy(aspirin+clopidogrel)and 5 patients were treated with anticoagulant therapy(heparin or warfarin)after TAVI.All indices did not change significantly(P>0.05)after treated with antithrombotic therapy before TAVI.In the antiplatelet group,PC reduced significantly on the same day after operation[112(80-142)×10~9/L VS 161(106-173)×10~9/L,P<0.05],and reached nadir of 66(49-94)×10~9on the second day,then rise gradually,but did not return to the preoperative level from the 6th to 9th day[130(117-142)×10~9/L VS 161(106-173)×10~9/L,P<0.05].PCT reduced significantly on the same day after operation[0.14%(0.10%-0.17%)VS 0.18%(0.13%-0.19%),P<0.05],and reached nadir of0.08%(0.06%-0.11%)on the second day,then rise gradually,but did not return to the preoperative level from the 6th to 9th day[0.15%(0.14%-0.15%)VS0.18%(0.13%-0.19%),P<0.05].MPV increased significantly on the same day after operation[11.8(11.3-11.9)fL VS 11.2(10.8-11.4)fL,P<0.05],reached the highest point of 11.9(11.2-12.4)fL on the second day,then reduced sharply on the third day,and returned to the preoperative level.PDW increased significantly on the first day after operation[14.5(13.1-16.0)fl VS 13.4(12.1-14.8)fl,P<0.05],and reached the highest point of 14.5(13.5-15.7)fl on the second day,then returned to the preoperative level on the third day.There was no significant change in RDW.MPR increased significantly on the same day after operation[0.10(0.08-0.15)VS 0.07(0.06-0.11),P<0.05],and reached the highest point of 0.18(0.12-0.24)on the second day,returned to the preoperative level on the 6th to 9th day.RPR increased significantly on the same day after operation[0.14(0.09-0.19)VS 0.1(0.07-0.14),P<0.05],and reached the highest point of 0.23(0.15-0.30)on the second day,returned to the preoperative level on the 6th to 9th day.In the anticoagulant group,the PC reduced gradually after operation,and reached nadir on the 3rd day[105(82-108)×10~9/L VS 135(120-158)×10~9/L,P<0.05],then returned to the preoperative level from 4th to 5th day.PCT reduced slightly after operation,and reduced to the nadir on the 3rd day[0.12(0.1-0.13)%VS0.15(0.13-0.19)%,P>0.05],returned to the preoperative level from 6th to 9th day.MPV reached the highest point on the second day after operation[11.9(11.0-12.4)fL VS 11.6(10.7-12.1)fL,P>0.05],returned to the preoperative level from the 4th to5th day.PDW reached the highest point on the 3rd day[14.8(12.1-16.50)fl VS13.7(13.3-15.5)fl,P>0.05],returned to the preoperative level from 6th to 9th day after operation.There was no significant change in RDW.MPR increased significantly on the second day after operation[0.11(0.09-0.17)VS 0.09(0.07-0.09),P<0.05],reached the highest point of 0.11(0.1-0.17)on the third day,and returned to the preoperative level on the 4th and 5th day.RPR increased significantly on the second day[0.15(0.12-0.20)VS 0.11(0.09-0.13),P<0.05],reached the highest point of 0.16(0.13-0.20)on the third day,and returned to the preoperative level on the 6th to9th day.Correlation analysis showed that there was a negative correlation between the maximum point of MPV and the lowest point of PC(r=-0.508,P<0.05),a negative correlation between the maximum point of PDW and the lowest point of PC(r=-0.465,P<0.05);there was a positive correlation between the lowest point of PCT and the lowest point of PC(r=0.98,P<0.05),a positive correlation between the maximum point of MPV and the maximum point of PDW(r=0.854,P<0.05).Compared with the anticoagulant group,the changes of routine blood test indices in the antiplatelet group were more significantly,PC and PCT were not returned to the preoperative level on the 6th to 9th day after operation,and in the anticoagulation group they were more stably,and returned to the preoperative level in a short-term basically.Conclusions:PC and PCT reduced significantly after TAVI,then returned gradually in a short-term.MPV,PDW,MPR and RPR increased after TAVI,then returned to the preoperative level in a short-term.There was no significant change in RDW.Compared with the anticoagulant group,the changes of routine blood test indices in the antiplatelet group were more significantly,which may suggest that bleeding events are more likely to occur after TAVI. |
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