Long-Term Risk of Stroke After Transcatheter Aortic Valve Replacement: Insights from the SwissTAVI Registry

Stroke after transcatheter aortic valve implantation (TAVI) is associated with considerably worse postinterventional outcomes. However, predictors of stroke and the long-term risk after TAVI remain unknown. In this study from the SwissTAVI registry, the authors aimed to investigate the short- and long-term incidence and predictors of stroke following TAVR. A total of 11,957 patients (mean age 81.8 ± 6.5 years, 48.0 percent female) who underwent TAVI between 2011 and 2021 were included in the analysis. History of a previous stroke (11.8 percent) and atrial fibrillation (32.3 percent) were common among the analyzed patients. The thirty-day incidence of stroke was 3.0 percent, with 69 percent of the strokes occurring within the first 48 hours after TAVI. The incidence of stroke was 4.3 percent at one year and 7.8 percent at five years. After adjusting for matched comparison with same age and sex general population, the risk of stroke was significantly higher in the TAVI population during the first two years after TAVI. In the first year, SSR is 7.26 (95 percent CI: 6.3-8.36) and 6.82 (95 percent CI: 5.97-7.79) for males and females, respectively. In the second year, SSR is 1.98 (95 percent CI: 1.47-2.67) and 1.48 (95 percent CI: 1.09-2.02) for males and females, respectively. The authors concluded that TAVI patients experienced a higher risk of stroke up to two years after TAVI and a comparable risk after that.