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Aortic Valve Calcium Score Is Associated With Acute Stroke in Transcatheter Aortic Valve Replacement Patients

Michael Foley1,2, Kerry Hall2, James P Howard1,2

  • 1National Heart and Lung Institute, Imperial College London, London, United Kingdom.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 22, 2022
PubMed

Insights

Aortic valve calcium score on pre-transcatheter aortic valve replacement (TAVR) computed tomography is a significant predictor of acute stroke. This finding helps identify patients at higher risk for stroke during TAVR procedures.

Area of Science:

  • Cardiology
  • Radiology
  • Neurology

Background:

  • Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis in high-risk patients.
  • Stroke is a serious complication of TAVR, necessitating identification of at-risk individuals.

Purpose of the Study:

  • To determine if pre-TAVR aortic valve calcium score from computed tomography predicts acute stroke in TAVR patients.

Main Methods:

  • Retrospective observational cohort study of 433 TAVR patients (Jan 2017-Dec 2019).
  • Analysis included aortic valve calcium score, patient demographics, and stroke occurrence up to discharge.

Main Results:

  • Aortic valve calcium score was significantly associated with acute stroke (OR, 1.26; P=.02).
  • Peripheral arterial disease (OR, 4.32; P=.0018) and longer procedure time (OR, 1.01; P=.0006) also predicted stroke.

Conclusions:

  • Pre-TAVR aortic valve calcium score is an independent risk factor for periprocedural stroke.
  • This score offers additional clinical value for assessing stroke risk in TAVR candidates.
Abstract

Keywords:
AF, atrial fibrillationAU, Agatston unitsAortic stenosisCEPD, cerebral embolic protection deviceCT, computed tomographyIQR, interquartile rangeLVOT, left ventricular outflow tractPAD, peripheral arterial diseaseSAVR, surgical aortic valve replacementTAVR, transcatheter aortic valve replacementaortic valve calcium scorecomputed tomographystroketranscatheter aortic valve replacement

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