Author + information
- Ajar Kochar,
- Zhuokai Li,
- John Harrison,
- G. Chad Hughes,
- Vinod Thourani,
- Michael Mack,
- David Cohen,
- Eric Peterson,
- William Jones and
- Sreekanth Vemulapalli
Background: Stroke is a known complication of both TAVR and Carotid Disease (CD). Implications of CD in patients undergoing TAVR are unclear.
Methods: We used the STS/ACC TVT Registry linked with Medicare claims to evaluate patients undergoing TAVR from 2013-2015 with and without CD. Unadjusted: mortality, new-dialysis rates, and stroke outcomes at 1 year are presented using Gray's method of cumulative incidence.
Results: Among 29,143 patients undergoing TAVR, 6410 (22%) had CD. Patients with CD had higher rates of prior hypertension, diabetes, TIA, stroke, and MI. CD is associated with higher rate of in-hospital stroke (2.6% with CD versus 2.0% without CD, p = 0.003) and mortality (4.4% with CD versus 3.5% without CD, p = 0.0006). There was no difference in the cumulative incidence rate for stroke at 1 year between patients with and without CD (4.5% versus 4.1%, p = 0.16). CD compared with absence of CD is associated with higher unadjusted cumulative incidence rates of: myocardial infarction (2.8% versus 1.9%, p < 0.001), new dialysis (3.7% versus 2.5%, p < 0.001) and mortality (21.5% versus 19.9%, p = 0.002).
Conclusions: CD in patients undergoing TAVR is associated with worse in-hospital and 1 year cardiovascular outcomes including mortality. Patients with CD undergoing TAVR should be counseled that they are at an increased risk for adverse complications; although 1 year stroke outcomes appear similar.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: TAVR 3
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1243-185
- 2017 American College of Cardiology Foundation