Risk of ischemic stroke much smaller with TAVR than SAVR when patient has a history of stroke
Among patients with a history of stroke, transcatheter aortic valve replacement (TAVR) is associated with a lower short-term risk of ischemic stroke (IS) than surgery, according to new research published in the American Journal of Cardiology.
“Some studies have suggested a lower risk of stroke in TAVR compared with surgical aortic valve replacement (SAVR), while others have reported similar IS risk,” wrote lead author Tomo Ando, MD, a cardiologist at Kawasaki Saiwai Hospital in Japan, and colleagues. “It is unknown, however, whether TAVR or SAVR preferentially have different risks of perioperative IS in high-risk patients such as those with prior history of stroke.”
The team tracked patient data from October 2015 to November 2017. All data came from the Nationwide Readmission Database.
The study included more than 92,000 TAVR patients and more than 68,000 SAVR patients. While 14.4% of TAVR patients had a prior stroke, that number was 7.8% for SAVR patients.
Overall, the authors found, TAVR and SAVR were linked to a similar risk of in-hospital IS if the patient did not have a history of prior stroke. When there was a history of prior stroke, however, the difference in in-hospital IS risk was substantial: 3.7% for TAVR patients and 8% for SAVR.
This same trend was seen when it came to short-term IS risk. The risk was similar when patients had no history of prior stroke, but TAVR was associated with a much lower short-term IS risk (4.6%) than SAVR (8.6%) when the patient did present with such a history. Factors such as age, chronic kidney disease, obesity and diabetes did not appear to make a significant impact on these statistics.
TAVR was also associated with lower in-hospital mortality, acute kidney injury and bleeding rates than SAVR among patients with a history of stroke.
“This analysis of a national claims database showed that TAVR was associated with a lower risk of in-hospital IS compared with SAVR among patients with prior stroke,” the authors concluded.
Read the full analysis here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.