000			03269nam a22003497a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a1061-5377
024			_a00045415-990000000-00225 [pii]
040			_aOvid MEDLINE(R)
099			_a38436403
245			_aExamining the Role of Cerebral Embolic Protection Devices in Preventing Postoperative Stroke in Patients with a History of Stroke or Transient Ischemic: Insights from the National Inpatient Sample.
251			_aCardiology in Review. 2024 Mar 04
252			_aCardiol Rev. 2024 Mar 04
253			_aCardiology in review
260			_c2024
260			_p2024 Mar 04
265			_saheadofprint
265			_tPublisher
266			_d2024-07-23
501			_aAvailable online from MWHC library: 2001 - present
520			_aCerebral embolic protection devices (CEPD) during transcatheter aortic valve replacement (TAVR) have been shown to lower the risk of stroke during the procedure. However, their long-term and clinical effects on neuro-cognition are unknown. Therefore, we hypothesized the benefit of CEPD in TAVR patients with a prior history of stroke or transient ischemic attack (TIA). National Inpatient Sample (2019) and International Classification of Diseases, 10th Revision codes were used to identify patients undergoing TAVR with prior stroke or TIA. Propensity-matched analysis was performed to adjust for baseline characteristics and comorbidities. Primary outcome measures were postoperative stroke and all-cause mortality. Length of stay and hospital cost were secondary outcomes. Of 8450 unmatched TAVR patients with prior stroke or TIA in 2019, 1095 (13%) utilized CEPD. After propensity matching previous myocardial infarction (MI), coronary artery bypass grafting, and drug abuse were higher in the TAVR-only cohort. Postoperative stroke rate (1.4% vs 2.2%; P = 0.081) and odds [adjusted odds ratio (aOR), 0.48; 95% confidence interval (CI), 0.11-2.17; P = 0.341] were lower in the CEPD group. There was no difference in all-cause in-hospital mortality between the 2 groups (0.9% vs 1.0%). Length of stay (3 vs 2 days, P <0.001) and hospital expenditure ( _172,711 vs _162,284; P = 0.002) were higher for the TAVR-only cohort. CEPD in TAVR patients with prior stroke or TIA did not show statistically significant postoperative stroke benefits. However, further larger-scale prospective studies are needed to evaluate the long-term neurocognitive benefits of CEPD in these patients. As the use of TAVR continues to expand, optimizing peri-procedural strategies such as the use of CEPD remains a critical area of research to improve patient outcomes. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
546			_aEnglish
650			_zAutomated
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Union Memorial Hospital
656			_aInternal Medicine Residency
657			_aJournal Article
700			_aPingili, Adhvithi _bMUMH _cInternal Medicine Residency _dMBBS
790			_aDesai R, Mondal A, Katukuri N, Pingili A, Borra V, Nayak PR, Jain A, Patel H, Qaqish O, Vyas A, Kondur A
856			_uhttps://dx.doi.org/10.1097/CRD.0000000000000674 _zhttps://dx.doi.org/10.1097/CRD.0000000000000674
942			_cART _dArticle
999			_c14224 _d14224