Key result
Among 958 TAVI patients, a history of previous stroke (n=55) was significantly associated with higher all-cause mortality, but not with higher rates of procedural cerebrovascular insult.
Why the study?
Data concerning the impact of previous stroke on procedural stroke and on long-term survival after TAVI were lacking.
Does a history of previous stroke increase the risk of procedural cerebrovascular insult and long-term all-cause mortality in patients undergoing TAVI?
Cohort (n=958)
Does a history of previous stroke increase the risk of procedural cerebrovascular insult and long-term all-cause mortality in patients undergoing TAVI?
A history of stroke prior to TAVI predicts higher long-term all-cause mortality but does not increase the risk of procedural stroke.
Answers are grounded in this paper and cite their sources.
Prior stroke history may refine long-term mortality risk counseling in TAVI without changing procedural stroke precautions; extends risk models but leaves causal inference open.
BACKGROUND: In TAVI procedural stroke is one of the most feared complications and for this reason also extensively studied. But there is a lack of data concerning the impact of previous stroke on procedural stroke and on long-term survival. The aim of this registry-based cohort study is to evaluate the prevalence of previous stroke in TAVI patients and its impact on procedural stroke risk as well as long-term outcome. METHODS: We included all patients treated with TAVI between January 2007 and December 2020 and investigated concerning previous stroke in their medical history. Among 958 patients, 55 patients had previous stroke and were included in the present analysis. RESULTS: The salient finding of the present study is that previous stroke is significantly associated with higher all-cause mortality and has established itself as a predictor for poor outcome after TAVI. This is also observed after adjusting for confounders like EuroSCORE II (European system for cardiac operative risk evaluation) and AF (atrial fibrillation) as one of the main underlying diseases for cerebrovascular insult (CVI). However, previous stroke is not associated with higher rates of procedural CVI. CONCLUSION: A history of stroke is significantly associated with higher all-cause mortality and has established itself as a predictor for poor outcome after TAVI without higher rates of procedural stroke.
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Demirel et al. (2023) conducted a cohort in TAVI (n=958). Previous stroke vs. No previous stroke was evaluated on All-cause mortality and procedural cerebrovascular insult (CVI). Among 958 TAVI patients, a history of previous stroke (n=55) was significantly associated with higher all-cause mortality, but not with higher rates of procedural cerebrovascular insult.
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