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Late stroke after transcatheter aortic valve replacement : a nationwide study

Bjursten, Henrik LU ; Norrving, Bo LU and Ragnarsson, Sigurdur LU (2021) In Scientific Reports 11.
Abstract

Transcatheter aortic valve replacement (TAVR) is a rapidly growing field. Short-term safety and efficacy of these procedures have been studied extensively. However, little is known about the safety of these devices over time. Stroke is one feared long-term complication, and an increased stroke rate could affect guidelines for treating both the aortic stenosis and choosing antithrombotic therapy after TAVR. The primary objective was to study the incidence of stroke up to 8 years after TAVR implantation, comparing it with the risk of stroke in the general population. Secondary objectives were to study risk factors for late stroke and to study outcomes after stroke. A nationwide, all-comers study of patients who underwent TAVR in Sweden... (More)

Transcatheter aortic valve replacement (TAVR) is a rapidly growing field. Short-term safety and efficacy of these procedures have been studied extensively. However, little is known about the safety of these devices over time. Stroke is one feared long-term complication, and an increased stroke rate could affect guidelines for treating both the aortic stenosis and choosing antithrombotic therapy after TAVR. The primary objective was to study the incidence of stroke up to 8 years after TAVR implantation, comparing it with the risk of stroke in the general population. Secondary objectives were to study risk factors for late stroke and to study outcomes after stroke. A nationwide, all-comers study of patients who underwent TAVR in Sweden 2008–2018 was performed. The study was based on data from three national registries: a TAVR registry, a stroke registry, and a diagnosis registry. The main outcome was stroke incidence 30-days or more after TAVR implantation and was compared to a standardized incidence. The annual risk for stroke varied between 2.0% and 3.1% as compared to 1.5% and 1.9% in an age- and sex-matched cohort. Risk factors for developing stroke were reduced renal function, diabetes, history of stroke, age, and male sex. The 1-year mortality after stroke was 44%. This study demonstrated an increased rate of stroke after TAVR, but the findings suggest that this can in part be attributed to the group’s higher frequency of pre-disposing risk factors.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
11
article number
9593
publisher
Nature Publishing Group
external identifiers
  • scopus:85105424348
  • pmid:33953339
ISSN
2045-2322
DOI
10.1038/s41598-021-89217-0
project
Outcome after transcatheter valve interventions
Transcatheter treatment of structural heart disease
language
English
LU publication?
yes
additional info
Funding Information: Open access funding provided by Lund University. This work was supported by regional research fund and ALF-funds (Government Compensation to County Councils for Costs Arising from Research and Education), and Stiftelsen Färs and Frosta Sparbank. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
id
6de71c5a-c9a0-4701-bc3d-7840feec90bd
date added to LUP
2021-05-23 13:13:47
date last changed
2025-04-04 13:54:28
@article{6de71c5a-c9a0-4701-bc3d-7840feec90bd,
  abstract     = {{<p>Transcatheter aortic valve replacement (TAVR) is a rapidly growing field. Short-term safety and efficacy of these procedures have been studied extensively. However, little is known about the safety of these devices over time. Stroke is one feared long-term complication, and an increased stroke rate could affect guidelines for treating both the aortic stenosis and choosing antithrombotic therapy after TAVR. The primary objective was to study the incidence of stroke up to 8 years after TAVR implantation, comparing it with the risk of stroke in the general population. Secondary objectives were to study risk factors for late stroke and to study outcomes after stroke. A nationwide, all-comers study of patients who underwent TAVR in Sweden 2008–2018 was performed. The study was based on data from three national registries: a TAVR registry, a stroke registry, and a diagnosis registry. The main outcome was stroke incidence 30-days or more after TAVR implantation and was compared to a standardized incidence. The annual risk for stroke varied between 2.0% and 3.1% as compared to 1.5% and 1.9% in an age- and sex-matched cohort. Risk factors for developing stroke were reduced renal function, diabetes, history of stroke, age, and male sex. The 1-year mortality after stroke was 44%. This study demonstrated an increased rate of stroke after TAVR, but the findings suggest that this can in part be attributed to the group’s higher frequency of pre-disposing risk factors.</p>}},
  author       = {{Bjursten, Henrik and Norrving, Bo and Ragnarsson, Sigurdur}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Late stroke after transcatheter aortic valve replacement : a nationwide study}},
  url          = {{http://dx.doi.org/10.1038/s41598-021-89217-0}},
  doi          = {{10.1038/s41598-021-89217-0}},
  volume       = {{11}},
  year         = {{2021}},
}