Impact of Prior Stroke or TIA on Post-Transcatheter Aortic Valve Replacement Outcomes: A Meta-Analysis of Prospective Studies

Authors

Adil Sarvar Mohammed
Darshan Bhatty
Shiva Narain Thiagarajan
Hafeezuddin Ahmed, Corewell Health
Tahniyath Sumera
Arshad Ali Mohd
Rabia Rukhshan
Prerana Sevella
Kesar Prajapati
Samir Vanani
Priyatham Gurram
Rupak Desai

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Journal of the Society for Cardiovascular Angiography & Interventions

Abstract

Background: Previous stroke or transient ischemic attack (TIA) forms a considerably high risk for adverse outcomes particularly in people undergoing transcatheter aortic valve replacement (TAVR). However, The prognostic implications of a history of stroke/TIA was not well established. In this analysis, the aim was to assess the impact of a prior stroke/ TIA on outcomes and mortality rates after a TAVR procedure. Methods: A comprehensive literature search was performed in PubMed and Google Scholar to identify relevant studies. The primary outcome studied was all-cause mortality (ACM). Binary random-effects models were employed to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). Heterogeneity using I2 statistics and a leave one out sensitivity analysis were performed. Results: Three studies encompassing 1,768 patients were included, with a mean age of 81.8. They have higher rates of comorbidities like atrial fibrillation (42.6%), hypertension (92.7%), and diabetes (30%), with an STS score of 7.8. The pooled analysis demonstrated an adjusted OR of 1.51 (95% CI: 0.99–2.30, P¼0.06; I^2¼43.8%) for post-TAVR ACM in patients with a history of stroke/TIA. A leave-one-out sensitivity analysis confirmed that the results were not influenced by any one particular study. Conclusions: While the results showed borderline significance, the findings suggest a potential association between a history of stroke/TIA and higher ACM after TAVR. Further research with larger sample sizes may be warranted to confirm these observations.

Volume

3

Issue

5 Suppl

First Page

2

Comments

Society for Cardiovascular Angiography & Interventions 2024 SCAI Scientific Sessions, May 2-4, 2024, Long Beach, CA

Recommended Citation

Mohammed AS, Bhatty D, Thiagarajan SN, Ahmed H, Sumera T, Mohd AA, et al. Impact of prior stroke or TIA on post-transcatheter aortic valve replacement outcomes: a meta-analysis of prospective studies. J Soc Cardiovasc Angiogr Interv. 2024 May;3(5 Suppl):2. doi:10.1016/j.jscai.2024.101759

DOI

10.1016/j.jscai.2024.101759