Clinical Predictors for Procedural Stroke and Implications for Embolic Protection Devices during TAVR : Results from the Multicenter Transcatheter Aortic Valve Replacement In-Hospital Stroke (TASK) Study
Background: Data to support the routine use of embolic protection devices for stroke prevention during transcatheter aortic valve replacement (TAVR) are controversial. Identifying patients at high risk for peri-procedural cerebrovascular events may facilitate effective patient selection for embolic protection devices during TAVR. Aim: To generate a risk score model for stratifying TAVR patients according to peri-procedural cerebrovascular events risk. Methods and results: A total of 8779 TAVR patients from 12 centers worldwide were included. Peri-procedural cerebrovascular events were defined as an ischemic stroke or a transient ischemic attack occurring ≤24 h from TAVR. The peri-procedural cerebrovascular events rate was 1.4% (n = 127), which was independently associated with 1-year mortality (hazards ratio (HR) 1.78, 95% confidence interval (CI) 1.06−2.98, p < 0.028). The TASK risk score parameters were history of stroke, use of a non-balloon expandable valve, chronic kidney disease, and peripheral vascular disease, and each parameter was assigned one point. Each one-point increment was associated with a significant increase in peri-procedural cerebrovascular events risk (OR 1.96, 95% CI 1.56−2.45, p < 0.001). The TASK score was dichotomized into very-low, low, intermediate, and high (0, 1, 2, 3−4 points, respectively). The high-risk TASK score group (OR 5.4, 95% CI 2.06−14.16, p = 0.001) was associated with a significantly higher risk of peri-procedural cerebrovascular events compared with the low TASK score group. Conclusions: The proposed novel TASK risk score may assist in the pre-procedural risk stratification of TAVR patients for peri-procedural cerebrovascular events.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Journal of personalized medicine - 12(2022), 7 vom: 28. Juni |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Berkovitch, Anat [VerfasserIn] |
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| Links: |
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| Themen: |
Aortic stenosis |
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| Anmerkungen: |
Date Revised 08.03.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/jpm12071056 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344073483 |
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| 100 | 1 | |a Berkovitch, Anat |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical Predictors for Procedural Stroke and Implications for Embolic Protection Devices during TAVR |b Results from the Multicenter Transcatheter Aortic Valve Replacement In-Hospital Stroke (TASK) Study |
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| 520 | |a Background: Data to support the routine use of embolic protection devices for stroke prevention during transcatheter aortic valve replacement (TAVR) are controversial. Identifying patients at high risk for peri-procedural cerebrovascular events may facilitate effective patient selection for embolic protection devices during TAVR. Aim: To generate a risk score model for stratifying TAVR patients according to peri-procedural cerebrovascular events risk. Methods and results: A total of 8779 TAVR patients from 12 centers worldwide were included. Peri-procedural cerebrovascular events were defined as an ischemic stroke or a transient ischemic attack occurring ≤24 h from TAVR. The peri-procedural cerebrovascular events rate was 1.4% (n = 127), which was independently associated with 1-year mortality (hazards ratio (HR) 1.78, 95% confidence interval (CI) 1.06−2.98, p < 0.028). The TASK risk score parameters were history of stroke, use of a non-balloon expandable valve, chronic kidney disease, and peripheral vascular disease, and each parameter was assigned one point. Each one-point increment was associated with a significant increase in peri-procedural cerebrovascular events risk (OR 1.96, 95% CI 1.56−2.45, p < 0.001). The TASK score was dichotomized into very-low, low, intermediate, and high (0, 1, 2, 3−4 points, respectively). The high-risk TASK score group (OR 5.4, 95% CI 2.06−14.16, p = 0.001) was associated with a significantly higher risk of peri-procedural cerebrovascular events compared with the low TASK score group. Conclusions: The proposed novel TASK risk score may assist in the pre-procedural risk stratification of TAVR patients for peri-procedural cerebrovascular events | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a aortic stenosis | |
| 650 | 4 | |a stroke | |
| 650 | 4 | |a transcatheter aortic valve replacement | |
| 700 | 1 | |a Segev, Amit |e verfasserin |4 aut | |
| 700 | 1 | |a Maor, Elad |e verfasserin |4 aut | |
| 700 | 1 | |a Sedaghat, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Finkelstein, Ariel |e verfasserin |4 aut | |
| 700 | 1 | |a Saccocci, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Kornowski, Ran |e verfasserin |4 aut | |
| 700 | 1 | |a Latib, Azeem |e verfasserin |4 aut | |
| 700 | 1 | |a De La Torre Hernandez, Jose M |e verfasserin |4 aut | |
| 700 | 1 | |a Søndergaard, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a Mylotte, Darren |e verfasserin |4 aut | |
| 700 | 1 | |a Van Royen, Niels |e verfasserin |4 aut | |
| 700 | 1 | |a Zaman, Azfar G |e verfasserin |4 aut | |
| 700 | 1 | |a Robert, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Sinning, Jan-Malte |e verfasserin |4 aut | |
| 700 | 1 | |a Steinvil, Arie |e verfasserin |4 aut | |
| 700 | 1 | |a Maisano, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Orvin, Katia |e verfasserin |4 aut | |
| 700 | 1 | |a Iannopollo, Gianmarco |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Dae-Hyun |e verfasserin |4 aut | |
| 700 | 1 | |a De Backer, Ole |e verfasserin |4 aut | |
| 700 | 1 | |a Mercanti, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a van der Wulp, Kees |e verfasserin |4 aut | |
| 700 | 1 | |a Shome, Joy |e verfasserin |4 aut | |
| 700 | 1 | |a Tchétché, Didier |e verfasserin |4 aut | |
| 700 | 1 | |a Barbash, Israel M |e verfasserin |4 aut | |
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