TY  - BOOK
AU  - Pichard, Augusto D
TI  - Insights Into Timing, Risk Factors, and Outcomes of Stroke and Transient Ischemic Attack After Transcatheter Aortic Valve Replacement in the PARTNER Trial (Placement of Aortic Transcatheter Valves)
SN  - 1941-7640
PY  - 2016///
KW  - *Aortic Valve Insufficiency/su [Surgery]
KW  - *Aortic Valve Stenosis/su [Surgery]
KW  - *Ischemic Attack, Transient/ep [Epidemiology]
KW  - *Stroke/ep [Epidemiology]
KW  - *Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Insufficiency/dg [Diagnostic Imaging]
KW  - Aortic Valve Insufficiency/mo [Mortality]
KW  - Aortic Valve Stenosis/dg [Diagnostic Imaging]
KW  - Aortic Valve Stenosis/mo [Mortality]
KW  - Cardiac Catheterization
KW  - Female
KW  - Femoral Artery
KW  - Humans
KW  - Incidence
KW  - Ischemic Attack, Transient/di [Diagnosis]
KW  - Ischemic Attack, Transient/mo [Mortality]
KW  - Ischemic Attack, Transient/th [Therapy]
KW  - Kaplan-Meier Estimate
KW  - Male
KW  - Punctures
KW  - Registries
KW  - Risk Assessment
KW  - Risk Factors
KW  - Stroke/di [Diagnosis]
KW  - Stroke/mo [Mortality]
KW  - Stroke/th [Therapy]
KW  - Time Factors
KW  - Transcatheter Aortic Valve Replacement/mo [Mortality]
KW  - Transcatheter Aortic Valve Replacement/mt [Methods]
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 2008 - present
N2  - BACKGROUND: Prior studies of stroke and transient ischemic attack (TIA) after transcatheter aortic valve replacement (TAVR) are limited by reporting and follow-up variability. This is a comprehensive analysis of time-related incidence, risk factors, and outcomes of these events; CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00530894; CONCLUSIONS: Risk of stroke or TIA is highest early after TAVR and is associated with increased 1-year mortality. Modifications of TAVR, emboli-prevention devices, and better intraprocedural pharmacological protection may mitigate this risk; Copyright � 2016 American Heart Association, Inc; METHODS AND RESULTS: From April 2007 to February 2012, 2621 patients, aged 84+/-7.2 years, underwent transfemoral (TF; 1521) or transapical (TA; 1100) TAVR in the PARTNER trial (Placement of Aortic Transcatheter Valves; as-treated), including the continued access registry. Stroke and TIA were identified by protocol and adjudicated by a Clinical Events Committee. Within 30 days of TAVR, 87 (3.3%) patients experienced a stroke (TF 58 [3.8%]; TA 29 [2.7%]; P=0.09), 85% within 1 week. Instantaneous stroke risk peaked on day 2, then fell to a low prolonged risk of 0.8% by 1 to 2 weeks. Within 30 days, 13 (0.50%) patients experienced a TIA (TF 10 [0.67%]; TA 3 [0.27%]; P>0.17). Stroke and TIA were associated with lower 1-year survival than expected (TF 47% after stroke versus 82%, and 64% after TIA versus 83%; TA 53% after stroke versus 80%, and 64% after TIA versus 83%). Risk factors for early stroke after TA-TAVR included more postdilatations, pure aortic stenosis without regurgitation, and possibly more pacing runs, earlier date of procedure, and no dual antiplatelet therapy; high pre-TAVR aortic peak gradient was a risk factor for stroke early after TF-TAVR
UR  - https://dx.doi.org/10.1161/CIRCINTERVENTIONS.115.002981
ER  -