Introduction:
Stroke after transcatheter aortic valve replacement (TAVR) is a significant cause of morbidity and mortality. It increases the risk of mortality threefold, within one year of TAVR. It is also associated with significant disability and increased health care costs. A validated risk prediction tool for stroke one year after TAVR may be useful in risk stratification to guide decisions at the point of clinical care and in research. The objective of this study was to assess the calibration and discriminative ability of the R
2
CHA
2
DS
2
VASc, CHA
2
DS
2
VASc, R
2
CHADS
2
, and CHADS
2
scores for predicting stroke within one year of TAVR.
Methods:
This was a retrospective cohort study using data from a midwestern academic center TAVR program. Patients who underwent TAVR from 2012 to the first quarter of 2018 who had one-year follow-up data were included in the study. The model discrimination and calibration were assessed using the area under the receiver operating characteristic curve (c-statistic) and the Hosmer-Lemeshow test respectively.
Results:
Six hundred and sixty four patients met the inclusion criteria and 3.4% had stroke within one year of undergoing TAVR. They had a median age of 81 years and a mean STS score of 6.3. The R
2
CHA
2
DS
2
VASc, CHA
2
DS
2
VASc, R
2
CHADS
2
, and CHADS
2
scores had c-statistics of 0.591, 0.596, 0.607, and 0.622, respectively. The Hosmer-Lemeshow χ
2
p-values were 0.762, 0.422, 0.463 and 0.146 respectively.
Conclusion:
The CHADS
2
score had the best discriminative ability for stroke prediction one year after TAVR. All the four scores were well calibrated.
Preoperative Left Ventricular Diastolic Dysfunction and One-Year Survival in Patients Undergoing Transcatheter Aortic Valve Replacement
