Stroke risk after transcatheter aortic valve replacement in patients with carotid stenosis: A systematic review and meta-analysis.
Int J Cardiol
; 408: 132085, 2024 Aug 01.
Article
in En
| MEDLINE
| ID: mdl-38702030
ABSTRACT
BACKGROUND:
Stroke is a feared complication of transcatheter aortic valve replacement (TAVR). Patients undergoing TAVR typically have multiple comorbidities, such as carotid artery stenosis (CAS). We conducted the present meta-analysis to determine the risk of stroke and mortality following TAVR in patients with CAS.METHODS:
We searched PubMed/Medline, Scopus, ScienceDirect, and Cochrane Clinical Trials databases for clinical studies that compared CAS ≥50% and CAS ≥70% versus non-CAS TAVR population. The endpoints included the 30-day incidence of stroke or transient ischemic attack (TIA) and 30-day all-cause of mortality.RESULTS:
We identified seven studies that included 12,418 patients in the CAS group and 102,316 in the control group. CAS ≥50% was not associated with an increased risk of 30-day stroke or TIA after TAVR [risk ratio (RR) 1.38; 95% confidence interval (95% CI) 0.95-2.02; p = 0.09]. However, patients with CAS ≥70% had an increased risk of stroke or TIA (RR 1.43; 95% CI 1.02-2.01; p = 0.04). No difference in 30-day all-cause mortality was observed between CAS ≥50% or CAS ≥70% and control groups (RR 1.09; 95% CI 0.79-1.52; p = 0.59 and RR 1.11; 95% CI 0.85-1.45; p = 0.43, respectively).CONCLUSIONS:
CAS ≥70% was associated with an increased risk of stroke or TIA following TAVR compared with patients without CAS.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Valve Stenosis
/
Carotid Stenosis
/
Stroke
/
Transcatheter Aortic Valve Replacement
Limits:
Humans
Language:
En
Journal:
Int J Cardiol
Year:
2024
Document type:
Article
Country of publication:
HOLANDA
/
HOLLAND
/
NETHERLANDS
/
NL
/
PAISES BAJOS
/
THE NETHERLANDS