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Long-Term Risk of Stroke After Transcatheter Aortic Valve Replacement: Insights From the SwissTAVI Registry.
Okuno, Taishi; Alaour, Bashir; Heg, Dik; Tueller, David; Pilgrim, Thomas; Muller, Olivier; Noble, Stephane; Jeger, Raban; Reuthebuch, Oliver; Toggweiler, Stefan; Ferrari, Enrico; Templin, Christian; Wenaweser, Peter; Nietlispach, Fabian; Taramasso, Maurizio; Huber, Christoph; Roffi, Marco; Windecker, Stephan; Stortecky, Stefan.
Afiliación
  • Okuno T; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
  • Alaour B; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
  • Heg D; CTU Bern, University of Bern, Bern, Switzerland.
  • Tueller D; Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland.
  • Pilgrim T; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
  • Muller O; Department of Cardiology, Lausanne University Hospital - CHUV, Lausanne, Switzerland.
  • Noble S; Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland.
  • Jeger R; Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland; University of Basel, Basel, Switzerland.
  • Reuthebuch O; University of Basel, Basel, Switzerland; Department of Cardiovascular Surgery, Basel University Hospital, University of Basel, Basel, Switzerland.
  • Toggweiler S; Cantonal Hospital Lucerne, Lucerne, Switzerland.
  • Ferrari E; Department of Cardiovascular Surgery, Cardiocentro Ticino Institute, Lugano, Switzerland.
  • Templin C; Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland.
  • Wenaweser P; Heart Clinic Hirslanden, Hirslanden Clinic Zurich, Zurich, Switzerland.
  • Nietlispach F; Cardiovascular Center Zurich, Hirslanden Klinik Im Park, Zurich, Switzerland.
  • Taramasso M; Heart Center Hirslanden, Hirslanden Clinic Zurich, Zurich, Switzerland.
  • Huber C; Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland.
  • Roffi M; Division of Cardiology and Cardiovascular Surgery, University Hospital, Geneva, Switzerland.
  • Windecker S; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
  • Stortecky S; Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: stefan.stortecky@insel.ch.
JACC Cardiovasc Interv ; 16(24): 2986-2996, 2023 Dec 25.
Article en En | MEDLINE | ID: mdl-38151313
ABSTRACT

BACKGROUND:

Stroke after transcatheter aortic valve replacement (TAVR) is associated with considerable morbidity and mortality. Predictors of stroke and the long-term risk after TAVR remain incompletely understood.

OBJECTIVES:

The authors sought to investigate the short- and long-term incidence and predictors of stroke after TAVR in the SwissTAVI Registry.

METHODS:

Between February 2011 and June 2021, consecutive patients undergoing TAVR were included. Standardized stroke ratios (SSRs) were calculated to compare trends in stroke of TAVR patients with an age- and sex-matched general population in Switzerland derived from the 2019 Global Burden of Disease study.

RESULTS:

A total of 11,957 patients (81.8 ± 6.5 years of age, 48.0% female) were included. One-third of the patients (32.3%) had a history of atrial fibrillation, and 11.8% had a history of cerebrovascular accident. The cumulative 30-day incidence rate of stroke was 3.0%, with 69% of stroke events occurring within the first 48 hours after TAVR. The incidence of stroke was 4.3% at 1 year, and 7.8% at 5 years. Compared with an age- and sex-adjusted general population, the risk of stroke was significantly higher in the TAVR population during the first 2 years after TAVR first year SSR 7.26 (95% CI 6.3-8.36) and 6.82 (95% CI 5.97-7.79) for males and females, respectively; second year SSR 1.98 (95% CI 1.47-2.67) and 1.48 (95% CI 1.09-2.02) for males and females, respectively; but returned to a comparable level to that observed in the matched population thereafter.

CONCLUSIONS:

Compared with an age- and sex-matched population, TAVR patients experienced a higher risk of stroke for up to 2 years after the procedure, and a comparable risk thereafter. (SwissTAVI Registry; NCT01368250).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Accidente Cerebrovascular / Reemplazo de la Válvula Aórtica Transcatéter Límite: Female / Humans / Male / Middle aged Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Accidente Cerebrovascular / Reemplazo de la Válvula Aórtica Transcatéter Límite: Female / Humans / Male / Middle aged Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos