000			04646nam a22008297a 4500
008			170410s20162016 xxu||||| |||| 00| 0 eng d
022			_a1878-0938
040			_aOvid MEDLINE(R)
099			_a27236630
245			_aThe impact of prior stroke on the outcome of patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.
251			_aCardiovascular Revascularization Medicine. 17(5):322-7, 2016 Jul-Aug
252			_aCardiovasc Revasc Med. 17(5):322-7, 2016 Jul-Aug
253			_aCardiovascular revascularization medicine : including molecular interventions
260			_c2016
260			_fFY2017
266			_d2017-04-10
501			_aAvailable in print through MWHC library: 2002 - present
520			_aAIMS: The present study aimed to evaluate the impact of prior cardiovascular events (CVE) on outcome in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).
520			_aCONCLUSION: Prior history of stroke infers a higher risk for in-hospital minor stroke, yet no impact on other outcomes post TAVR. Therefore, history of prior stroke should not be considered an exclusion criterion for TAVR in patients with severe AS.
520			_aCopyright © 2016 Elsevier Inc. All rights reserved.
520			_aMETHODS AND RESULTS: Patients with severe AS undergoing TAVR between May 2007 and March 2015 were included and categorized to patients with and without prior stroke, defined as embolic, hemorrhagic stroke and transit ischemic attack. Baseline, procedural characteristics, in-hospital outcomes, and 1-month and 1-year mortality were compared in accordance with the Valve Academic Research Consortium-2 consensus. A cohort of 662 consecutive patients with severe AS undergoing TAVR were included in the analysis. Of these, 120 patients had prior stroke, and 542 without. Transfemoral access was used in 78% (571), and pre-TAVR balloon aortic valvuloplasty was performed in 87% (574). Patients with prior stroke had a higher mean Society of Thoracic score compared to those without (10.1% versus 8.8%, respectively; p=0.006) and higher rates of atherosclerotic disease involving the coronary, peripheral, and carotid arteries. Patients with prior stroke also had more occurrence of in-hospital minor stroke (3.3% versus 0.7%; p=0.04). Nevertheless, similar mortality rates were recorded at 1, 6, and 12months, and there were no significant differences in major stroke, bleeding, or post-procedure hospital stay between both groups.
546			_aEnglish
650			_a*Aortic Valve
650			_a*Aortic Valve Stenosis/th [Therapy]
650			_a*Cardiac Catheterization/mt [Methods]
650			_a*Heart Valve Prosthesis Implantation/mt [Methods]
650			_a*Stroke/co [Complications]
650			_aAged
650			_aAged, 80 and over
650			_aAortic Valve Stenosis/dg [Diagnostic Imaging]
650			_aAortic Valve Stenosis/mo [Mortality]
650			_aAortic Valve Stenosis/pp [Physiopathology]
650			_aAortic Valve/dg [Diagnostic Imaging]
650			_aAortic Valve/pp [Physiopathology]
650			_aBalloon Valvuloplasty
650			_aCardiac Catheterization/ae [Adverse Effects]
650			_aCardiac Catheterization/mo [Mortality]
650			_aDistrict of Columbia
650			_aFemale
650			_aHeart Valve Prosthesis Implantation/ae [Adverse Effects]
650			_aHeart Valve Prosthesis Implantation/mo [Mortality]
650			_aHemorrhage/et [Etiology]
650			_aHumans
650			_aKaplan-Meier Estimate
650			_aLength of Stay
650			_aMale
650			_aPatient Selection
650			_aProportional Hazards Models
650			_aProspective Studies
650			_aRecurrence
650			_aRisk Assessment
650			_aRisk Factors
650			_aSeverity of Illness Index
650			_aStroke/di [Diagnosis]
650			_aStroke/mo [Mortality]
650			_aTime Factors
650			_aTreatment Outcome
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
657			_aObservational Study
700			_aDidier, Romain
700			_aKiramijyan, Starkis
700			_aKoifman, Edward
700			_aNegi, Smita I
700			_aOkubagzi, Petros
700			_aPichard, Augusto D
700			_aTorguson, Rebecca
700			_aWaksman, Ron
790			_aDidier R, Kiramijyan S, Koifman E, Negi SI, Okubagzi P, Pichard AD, Torguson R, Waksman R
856			_uhttps://dx.doi.org/10.1016/j.carrev.2016.05.003 _zhttps://dx.doi.org/10.1016/j.carrev.2016.05.003
942			_cART _dArticle
999			_c2058 _d2058