Page 20 - Journal of Structural Heart Disease Volume 4, Issue 1

11
Original Scienti c Article
Table 1. Non-adjusted baseline characteristics.
Table 2. Non-adjusted procedure characteristics.
Variable
No Carotid compression n=188
Carotid compression n= 118
p value
Variable
No Carotid Compression
Carotid Compression
p value
Age 81.9 ±
Females 48.5%
Caucasian race 93.1%
Diabetes 43.5%
Hypertension 96.1%
Atrial brillation 48.9%
Prior Stroke or 23.8% TIA
Prior MI 36.8%
Prior CAD 55.1% (CABG or PCI)
Current 6.9% Tobacco Use
COPD 34.4%
Prior PVD 40.4%
Carotid Stenosis 22.7% (L/R)
Baseline LVEF 93.3% (>30%)
BMI 28.5 ± STS Score 8.47 ±
8.1
<0.001 0.05 0.06 0.52 0.003 0.008 0.20
0.002
0.22
0.83
0.11
0.02
0.14
0.13
28.3 ±
9.24 ±5.9 0.12
6.9 4.4
6.2 0.80
72.7 ± 90.7 0.03
78.8 ± 39.4% 97.1% 40.6% 89.7% 36.6% 18.9%
23.4% 49.4%
7.4%
27.4% 30.3% 17.1%
96.6%
7.3
LOS Post-Proce- dure (days)
Prior aortic valve procedure
Pre-procedure anticoagulants
Access Site
• TF
• TA + Other
Status
• Elective • Urgent/
Emergency
NYHA Class • Class I
• Class II
• Class III
• Class IV
Valve-in-valve
Annulus size
Procedure Time (minutes)
ICU Hours
6.8 ± 5.6
18.3%
43.8%
58.7% 41.3%
85.0% 15.0%
2.0% 6.0% 46.0% 46.0%
6.3 ± 4.8 0.28
6.9%
22.4 ± 141.2 ± 63.2
0.60 2.7 <0.001
2.3 54.5 ± 91.8
5.7%
23.4 ±
116.5 ± 63.2 <0.001
8.0%
28.0%
70.3% 29.7%
92.6% 7.4%
0% 5.7% 81.7% 12.6%
0.002 <0.001 0.01
0.01 <0.001
absence of other possible causes and was con rmed by a neurologist. Stroke was de ned as rapid onset of a focal or global neurological de cit lasting ≥24 hours (or <24 hours if therapeutic interventions were performed) in the absence of other identi able non- stroke causes and was con rmed by a neurologist. In keeping with the VARC recommendation, a disabling stroke (also known as a “major stroke”) was de ned as a stroke with degree of disability ≥2 on the mod- i ed Rankin scale. Post-procedure neurologic events (“post-procedure cardiovascular accidents (CVA)”) were de ned as any TIA or stroke documented with- in 72 hours of TAVR, whereas a late neurologic event (“late CVA”) was de ned as any TIA or stroke docu- mented between 72 hours of TAVR (or at discharge) and 30 days after TAVR. In this study, high-volume TAVR is de ned as >100 TAVR cases annually, with all three centers meeting this de nition. This study was
approved by the institutional review boards at all three centers.
Statistical Analysis
Baseline Comparison of Treatment Groups. Con- tinuous variables are presented as mean ± standard deviation (SD) or percentage based on their distribu- tion. In the overall sample, continuous and categori- cal variables were compared between groups using Student’s t-tests and Chi-square tests, respectively. Di erenceswereconsideredstatisticallysigni cantif P < 0.05.
Development of Propensity Score. One di culty in using observational data is that there may be di er- ent distributions of confounding variables between treatment and control groups. Propensity score analy- sis with inverse probability weighting (IPW) is a meth- od that can help address imbalances between treat-
Tandar A. et al.
Stroke Prevention with Carotid Compression During TAVR