{
  "abstract": "Background Stroke after transcatheter aortic valve implantation (TAVI) is an infrequent but serious complication with important impact on morbidity and mortality. Contemporary real-world evidence on the risk factors of early stroke after TAVI is scarce. We aimed to evaluate the incidence, temporal trends and predictors of in-hospital stroke after TAVI and to assess its association with mortality.Methods We conducted a retrospective, observational cohort study using data from the Netherlands Heart Registration of all TAVI procedures performed in the Netherlands between 2013 and 2023. The primary endpoint was the incidence of in-hospital stroke. The secondary endpoints were trends, mortality and risk factors associated with in-hospital stroke and early mortality as identified by logistic regression.Results Among 23 593 TAVI procedures, the overall incidence of in-hospital stroke was 2.0% and remained stable after an initial decline. Independent covariates associated with in-hospital stroke included female gender (OR 1.29; 95% CI 1.07 to 1.56), peripheral arterial disease (OR 1.55; 95% CI 1.24 to 1.93), non-transfemoral access (OR 1.54; 95% CI 1.21 to 1.93) and postdilation (OR 1.40; 95% CI 1.10 to 1.76). In-hospital stroke was strongly associated with an increased risk of mortality at 30 days (OR 8.54; 95% CI 6.56 to 11.02), and 1 year (OR 4.38; 95% CI 3.55 to 5.40).Conclusions In-hospital stroke remains an important complication after TAVI with a strong impact on mortality. Identification of high-risk patients and procedural optimisation is essential in optimisation of outcome.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands",
        "Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands"
      ],
      "name": "Simon E van Putten"
    },
    {
      "affiliations": [
        "Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands",
        "Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands"
      ],
      "name": "Romy R M J J Hegeman"
    },
    {
      "affiliations": [
        "Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands"
      ],
      "name": "Leo Timmers"
    },
    {
      "affiliations": [
        "Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands"
      ],
      "name": "Daniel C Overduin"
    },
    {
      "affiliations": [
        "Department of Medical Psychology, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands",
        "Public Health, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands"
      ],
      "name": "Pythia T Nieuwkerk"
    },
    {
      "affiliations": [
        "Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands"
      ],
      "name": "Joyce Peper"
    },
    {
      "affiliations": [
        "Netherlands Heart Registration, Utrecht, Netherlands"
      ],
      "name": "Maaike M Roefs"
    },
    {
      "affiliations": [
        "Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands"
      ],
      "name": "Uday Sonker"
    },
    {
      "affiliations": [
        "Department of Cardiothoracic Surgery, Leiden Universitair Medisch Centrum, Leiden, ZH, Netherlands"
      ],
      "name": "Benno J W M Rensing"
    },
    {
      "affiliations": [
        "Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands"
      ],
      "name": "Martin J Swaans"
    },
    {
      "affiliations": [
        "Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands",
        "Department of Cardiothoracic Surgery, Leiden Universitair Medisch Centrum, Leiden, ZH, Netherlands"
      ],
      "name": "Robert J M Klautz"
    },
    {
      "affiliations": [
        "Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands"
      ],
      "name": "Jurrien ten Berg"
    },
    {
      "affiliations": [
        "Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, Netherlands",
        "Department of Cardiothoracic Surgery, Amsterdam UMC Locatie AMC, Amsterdam, Netherlands"
      ],
      "name": "Patrick Klein"
    },
    {
      "affiliations": [],
      "name": "THI Registration Committee of the Netherlands Heart Registration"
    }
  ],
  "title": "Trends and risk factors of stroke and mortality after transcatheter aortic valve implantation in the Netherlands",
  "uid": "909b7428-53df-5e94-af2d-afd6b68537f5"
}