Valvular & structural heart disease
Incidence, Predictors, and Prognostic Impact of Neurologic Events After Transcatheter Aortic Valve Replacement (TAVR) According to VARC-3 Criteria
Authors' conclusion
Neurologic events after TAVR were associated with poorer short- and long-term survival. This correlation was related to the type of NeuroARC event defined by the VARC-3 criteria.
Study context
- Population
- Patients with severe AS undergoing TAVR
- Participants
- 2,924 patients
- Outcome
- Incidence, predictors and clinical impact of neurologic events (VARC-3/NeuroARC)
Methodological detailsprospectively collected data
- Prospectively collected data
Main finding
As reported in the abstract
Neurologic events · median follow-up 13 (7-37) months
- Neurologic events
- 471 patients (16.1%)
- Neurologic Academic Research Consortium (NeuroARC) type 1 (stroke)
- 37.4%
- NeuroARC type 2 (covert CNS injury)
- 4.7%
- NeuroARC type 3 (TIA and delirium)
- 58.0%
- Periprocedural
- 58.6%
Observational data: associations, not effects.
Further findings
Predictors of periprocedural neurologic events
- Advanced age, CKD, AF, major vascular complications and in-hospital bleeding increased risk
- P < 0.03 for all
1-year mortality with periprocedural neurologic events
- Periprocedural neurologic events, independently associated (HR)
- 1.91; 95% CI: 1.23-2.97; P = 0.004
Mortality by NeuroARC type
- NeuroARC type 1, ischemic stroke (IRR)
- 3.38; 95% CI: 2.30-5.56; P < 0.001
- NeuroARC type 1, hemorrhagic stroke (IRR)
- 21.7; 95% CI: 9.63-49.1; P < 0.001
- NeuroARC type 3 events had no impact on mortality
Original publication
Incidence, Predictors, and Prognostic Impact of Neurologic Events After TAVR According to VARC-3 Criteria. JACC Cardiovasc Interv. Published 12 August 2024. doi:10.
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