Abstract: FR-PO0581
Ischemic Stroke and Cardiovascular Outcomes After Transcatheter Aortic Valve Replacement in Patients with CKD
Session Information
- CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Scalia, Isabel Grace, Mayo Clinic Arizona, Scottsdale, Arizona, United States
- Ibrahim, Ramzi, Mayo Clinic Arizona, Scottsdale, Arizona, United States
- Farina, Juan, Mayo Clinic Arizona, Scottsdale, Arizona, United States
- Arsanjani, Reza, Mayo Clinic Arizona, Scottsdale, Arizona, United States
Background
Transcatheter aortic valve replacement (TAVR) is the predominant treatment for severe aortic stenosis. Despite technological advances, post-TAVR stroke rates remaine stable at 2-4%. Chronic kidney disease (CKD), present in 30-40% of TAVR patients, has been independently associated with poorer outcomes, however its relationship with post-TAVR stroke remains poorly defined.
Methods
Retrospective review was performed on all TAVR patients between 2010 and 2023 within the multicenter TriNetX research database. Patients were stratified by CKD (stage 3-5), excluding patients on kidney replacement therapy and those with bicuspid valves. A non-CKD cohort was established using 1:1 propensity score matching. Outcomes including ischemic stroke, mortality, all-cause hospitalization, atrial fibrillation, myocardial infarction and cardiac arrest were compared between cohorts and were considered between 30 days and 3 years post-TAVR, to minimize the impact of acute post-operative events.
Results
Of 33,141 TAVR patients, 22,789 had CKD. Following matching, 7,454 patients were included in each cohort. Patients with CKD had significantly higher rates of stroke (7.5% vs 5.6%; HR 1.29, 95% CI 1.14–1.46). CKD was also associated with increased all-cause mortality (HR 1.42, 95% CI 1.29–1.57), myocardial infarction (HR 1.81, 95% CI 1.58–2.08), cardiac arrest (HR 2.35, 95% CI 1.64–3.38), atrial fibrillation (HR 1.23, 95% CI 1.15–1.32), and all-cause hospitalization (HR 1.26, 95% CI 1.20–1.33) (all log-rank p<0.001).
Conclusion
In this large multicenter propensity matched cohort, CKD was independently associated with an increased risk of ischemic stroke and adverse cardiovascular outcomes post-TAVR. This high-risk subgroup may benefit from intensified pre-procedural risk factor optimization and future stroke-prevention strategies.