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Predictors of cerebrovascular events at mid-term after transcatheter aortic valve implantation - Results from EVERY-TAVI registry
- Source :
- International journal of cardiology. 244
- Publication Year :
- 2017
-
Abstract
- Background Clinical relevant cerebrovascular events (CVE) following transcatheter aortic valve implantation (TAVI) still remain a devastating complication associated with mortality and severe impairments. Therefore, identification of particularly modifiable predictors of this complication is clinically relevant and an important step for planning preventive strategies. Methods A total of 985 patients who underwent trans-femoral TAVI for aortic valve stenosis in our institution from February 2008 to January 2015 were considered. The influence of demographics, clinical and procedural data on the occurrence of CVE was assessed with a competing risk model with death as competing event. Clinical events were defined according to VARC-2 criteria. Results At a median follow-up of 838days, 95% CI 807–892, 59 patients experienced any CVE (5.9%) and the overall cumulative mortality rate was 46.1%. CVEs mainly occur later than 30days after TAVI (47.5%), 88.1% of them were of ischemic origin and 52.5% were disabling events. Independent predictors of CVEs were age (hazard ratio 1.05; 95% CI 1.01 to 1.09), history of CVE (hazard ratio 2.54; 95% CI 1.39 to 4.63) and use of balloon post-dilation (hazard ratio 1.85; 95% CI 1.08 to 3.18). Conclusion In patients undergoing TAVI incidence of clinically relevant CVEs is frequent with half of the events occurring after the first 30days post-TAVI. Identification of balloon post-dilation as the only modifiable predictor of CVE risk at mid-term, urges its cautious performance after prosthesis implantation. ClinicalTrials.gov identifier NCT02289339.
- Subjects :
- Male
medicine.medical_specialty
Transcatheter aortic
030204 cardiovascular system & hematology
Balloon
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Predictive Value of Tests
medicine
Humans
030212 general & internal medicine
Registries
Stroke
Aged
Aged, 80 and over
business.industry
Incidence (epidemiology)
Hazard ratio
Aortic Valve Stenosis
medicine.disease
Surgery
Cerebrovascular Disorders
Predictive value of tests
Aortic valve stenosis
Female
Cardiology and Cardiovascular Medicine
business
Complication
Follow-Up Studies
Subjects
Details
- ISSN :
- 18741754
- Volume :
- 244
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....c1f8bf338ee6a24dec8705ee6adcc3ea