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Ināhospital stroke after transcatheter aortic valve implantation: A UK observational cohort analysis
- Source :
- Catheterization and Cardiovascular Interventions. 97
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- OBJECTIVES We sought to identify baseline demographics and procedural factors that might independently predict in-hospital stroke following transcatheter aortic valve implantation (TAVI). BACKGROUND Stroke is a recognized, albeit infrequent, complication of TAVI. Established predictors of procedure-related in-hospital stroke; however, remain poorly defined. METHODS We conducted an observational cohort analysis of the multicenter UK TAVI registry. The primary outcome measure was the incidence of in-hospital stroke. RESULTS A total of 8,652 TAVI procedures were performed from 2007 to 2015. There were 205 in-hospital strokes reported by participating centers equivalent to an overall stroke incidence of 2.4%. Univariate analysis showed that the implantation of balloon-expandable valves caused significantly fewer strokes (balloon-expandable 96/4,613 [2.08%] vs. self-expandable 95/3,272 [2.90%]; p = .020). After multivariable analysis, prior cerebrovascular disease (CVD) (odds ratio [OR] 1.51, 95% confidence interval [CI 1.05-2.17]; p = .03), advanced age at time of operation (OR 1.02 [0.10-1.04]; p = .05), bailout coronary stenting (OR 5.94 [2.03-17.39]; p = .008), and earlier year of procedure (OR 0.93 [0.87-1.00]; p = .04) were associated with an increased in-hospital stroke risk. There was a reduced stroke risk in those who had prior cardiac surgery (OR 0.62 [0.41-0.93]; p = .01) and a first-generation balloon-expandable valve implanted (OR 0.72 [0.53-0.97]; p = .03). In-hospital stroke significantly increased 30-day (OR 5.22 [3.49-7.81]; p
- Subjects :
- Aortic valve
medicine.medical_specialty
030204 cardiovascular system & hematology
Cohort Studies
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Heart valve
Stroke
Univariate analysis
business.industry
Aortic Valve Stenosis
General Medicine
Odds ratio
medicine.disease
Hospitals
United Kingdom
Cardiac surgery
Treatment Outcome
medicine.anatomical_structure
Aortic Valve
Heart Valve Prosthesis
Aortic valve stenosis
Cardiology
Cardiology and Cardiovascular Medicine
business
Cohort study
Subjects
Details
- ISSN :
- 1522726X and 15221946
- Volume :
- 97
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....136f04ee6b4146b091c53e1de46ce617