Aortic Valve Calcium Score Is Associated With Acute Stroke in Transcatheter Aortic Valve Replacement Patients
Aortic Valve Calcium Score Is Associated With Acute Stroke in Transcatheter Aortic Valve Replacement Patients
复制标题
主动脉瓣钙化评分与经导管主动脉瓣置换术患者的急性卒中相关
DOI：
10.1016/j.carrev.2023.05.250
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发表时间：
2023
影响因子：
1.7
通讯作者：
Foley M
中科院分区：
文献类型：
--
作者：
Foley M
经导管主动脉瓣置换术(TAVR)是手术风险中等或较高的重度主动脉瓣狭窄患者的首选治疗方法。卒中是TAVR公认的严重并发症，识别卒中风险较高的患者是很重要的。本研究旨在探讨TAVR前CT计算的主动脉瓣钙化评分是否与TAVR患者的急性卒中有关。方法我们对2017年1月至2019年12月在Hammersmith医院连续接受TAVR的433名患者进行了回顾性的观察性队列研究。结果该队列患者的平均年龄为83岁(四分位数范围为78-87)，其中52.7%为男性。52例患者(12.0%)既往有中风或短暂性脑缺血发作病史。主动脉瓣钙积分中位数为2145(四分位数范围，1427~3247)阿加斯顿单位。22例患者在出院前有一次中风(5.1%)。在Logistic回归模型中，主动脉瓣钙化评分与急性卒中显著相关(优势比[OR]，1.26；95%可信区间[CI]，1.01-1.53；p=0.02)。急性卒中与外周动脉病变(OR4.32；95%CI1.65~10.65；p=0.0018)和较长的手术时间(OR1.01；95%CI1.00~1.02；p=0.0006)显著相关。这是TAVR术前主动脉瓣钙化评分的额外临床价值，在讨论围手术期卒中风险时应予以考虑。
BackgroundTranscatheter aortic valve replacement (TAVR) is the treatment of choice for patients with severe aortic stenosis who are at a moderate or higher surgical risk. Stroke is a recognised and serious complication of TAVR, and it is important to identify patients at higher stroke risk. This study aims to discover if aortic valve calcium score calculated from pre-TAVR computed tomography is associated with acute stroke in TAVR patients.MethodsWe conducted a retrospective, observational cohort study of 433 consecutive patients undergoing TAVR between January 2017 and December 2019 at the Hammersmith Hospital.ResultsThis cohort had a median age of 83 years (interquartile range, 78-87), and 52.7% were male. Fifty-two patients (12.0%) had a history of previous stroke or transient ischemic attack. Median aortic valve calcium score was 2145 (interquartile range, 1427-3247) Agatston units. Twenty-two patients had a stroke up to the time of discharge (5.1%). In a logistic regression model, aortic valve calcium score was significantly associated with acute stroke (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.01-1.53; p= 0.02). Acute stroke was also significantly associated with peripheral arterial disease (OR, 4.32; 95% CI, 1.65-10.65; p= 0.0018) and a longer procedure time (OR, 1.01; 95% CI, 1.00-1.02; p= 0.0006).ConclusionsAortic valve calcium score from pre-TAVR computed tomography is an independent risk factor for acute stroke in the TAVR population. This is an additional clinical value of the pre-TAVR aortic valve calcium score and should be considered when discussing periprocedural stroke risk.
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影响因子：
3.5
作者：
Ahmad, Yousif;Nijjer, Sukhjinder;Sen, Sayan
通讯作者：
Sen, Sayan
CT 在规划经导管主动脉瓣植入手术和风险评估中的应用。
影响因子：
2.6
作者：
A. Yucel;E. Nicol;J. Leipsic;J. Weir;J. Weir
通讯作者：
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DOI：
--
发表时间：
2017
期刊：
影响因子：
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作者：
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通讯作者：
S. Vemulapalli
影响因子：
2.3
作者：
Werner, Nicolas;Zeymer, Uwe;Zahn, Ralf
通讯作者：
Zahn, Ralf
既往中风患者经导管主动脉瓣植入术与手术主动脉瓣置换术的缺血性中风风险。
DOI：
10.1016/j.amjcard.2021.06.049
发表时间：
2021
期刊：
The American journal of cardiology
影响因子：
--
作者：
T. Ando;Said Ashraf;A. Briasoulis;H. Takagi;C. Grines;Aaqib H. Malik
通讯作者：
Aaqib H. Malik