AI Article Synopsis
- The study examines the use of cerebral embolic protection devices (CEPD) during transcatheter aortic valve implantation (TAVI) across US hospitals to understand their effectiveness in preventing strokes.
- Out of over 41,800 TAVI procedures analyzed, only 10.6% utilized CEPD, with 65.8% of hospitals not using these devices.
- Results indicated no significant differences in stroke or death rates between hospitals that used CEPD and those that did not, while costs were found to be lower in non-user hospitals.
Article Abstract
Background: The effectiveness of cerebral embolic protection devices (CEPD) in mitigating stroke after transcatheter aortic valve implantation (TAVI) remains uncertain, and therefore CEPD may be utilized differently across US hospitals. This study aims to characterize the hospital-level pattern of CEPD use during TAVI in the US and its association with outcomes.
Methods: Patients treated with nontransapical TAVI in the 2019 Nationwide Readmissions Database were included. Hospitals were categorized as CEPD non-users and CEPD users. The following outcomes were compared: the composite of in-hospital stroke or transient ischemic attack (TIA), in-hospital ischemic stroke, death, and cost of hospitalization. Logistic regression models were used for risk adjustment of clinical outcomes.
Results: Of 41,822 TAVI encounters, CEPD was used in 10.6% (n = 4422). Out of 392 hospitals, 65.8% were CEPD non-user hospitals and 34.2% were CEPD users. No difference was observed between CEPD non-users and CEPD users in the risk of in-hospital stroke or TIA (adjusted odds ratio (OR) = 0.99 [0.86-1.15]), ischemic stroke (adjusted OR = 1.00 [0.85-1.18]), or in-hospital death (adjusted OR = 0.86 [0.71-1.03]). The cost of hospitalization was lower in CEPD non-users.
Conclusions: Two-thirds of hospitals in the US do not use CEPD for TAVI, and no significant difference was observed in neurologic outcomes among patients treated at CEPD non-user and CEPD user hospitals.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692348 | PMC |
| http://dx.doi.org/10.1016/j.shj.2023.100202 | DOI Listing |
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