In-hospital stroke rates are much higher for patients undergoing transcatheter aortic valve replacement (TAVR) than those undergoing treatment with MitraClip, according to new findings published in the American Journal of Cardiology. Post-discharge stroke rates, however, were similar between the two procedures.
The authors explored the outcomes of more than 148,000 TAVR procedures and more than 15,000 MitraClip procedures from January 2014 to December 2017. All data came from the Nationwide Readmission Database.
Overall, 2% of TAVR patients and 1.1% of MC patients went on to develop in-hospital stroke. Another 0.6% of TAVR patients and 0.7% of MC patients developed stroke within 30 days of being discharged from the hospital.
TAVR was still associated with a higher risk of in-hospital stroke than MC after several adjustments—for age, the presence of atrial fibrillation (AFib) were made and so on—were made to the research team’s calculations.
“We cannot accurately specify the cause of relatively lower stroke rates in MC but we hypothesize that this may be because of the different underlying etiologies and thus mechanism of stroke,” wrote lead author Anas M. Saad, MD, of the Cleveland Clinic, and colleagues. “MC patients, specifically those with AFib where strokes are more likely to be related to thrombus formation, may benefit more from anticoagulation than protection devices, decreasing the incentive to experiment these devices with MC procedures.”
The authors also emphasized that hospital volume made “no difference” when it came to stroke rates following these procedures.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.