Risk of Ischemic Stroke in Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients With Prior Stroke
Section snippets
Methods
NRD between 2015 and 2017 (after October 1st for NRD 2015) was used to identify admissions with the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) (Supplemental Table 1). NRD is developed by the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project (www.hcup-us.ahrq.gov/nrdoverview.jsp). Briefly, the NRD is the largest publicly available all-payer in-patient readmission database in the United
Results
A total of weighted 92,435 TAVI (14.4% with prior stroke) and 68,651 SAVR (7.8% with prior stroke) were included in the analysis (Figure 1). Demographics of patients’ baseline comorbidities and hospital characteristics are summarized in Table 1.
TAVI resulted in significantly lower risk of in-hospital IS compared with SAVR in those with prior stroke (3.7% vs 8.0%, adjusted OR 0.65, 95% CI 0.47 to 0.89, p <0.001) but was similar between TAVI and SAVR without prior stroke (1.7% vs 2.1%, adjusted
Discussion
The main findings of our analyses are (1) TAVI had a significantly lower risk of in-hospital and short-term IS compared with SAVR among patients with prior IS but was similar among those without prior stroke, (2) the risk of in-hospital mortality, acute kidney injury, and bleeding requiring transfusions were significantly lower in TAVI than SAVR among patients with and without prior IS, (3) hospitalization cost was lower in TAVI as compared to SAVR among those with prior IS, whereas it did not
Disclosures
All authors have no disclosures.
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2023, Canadian Journal of CardiologyCitation Excerpt :The critical nature of overt stroke for cardiac procedures can lead to increased costs at the time of procedure as well as lengthened hospital stays.38,46 In a 2021 study, individuals who underwent a TAVR or SAVR procedure in the U.S. and experienced an overt stroke had mean increases in hospital stays of 5.5 and 5.8 days and mean increases in cost of approximately 18,000 USD and 21,000 USD respectively.38 For individuals undergoing PCI, the increase in cost was more than 60% (a mean increase of around 19,500 USD) and length of stay was at least twice as long as individuals without overt stroke.29
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There was no external funding for this study.