Today I will be discussing the presentation that I am discussing at ESC for moderated oral presentation and the topic is neuroprotective effect of aortic valve replacement, a propensity score matched retrospective cohort study. We don’t have any disclosures to disclose and I’m really grateful to all the co-authors involved in preparing this study. Aortic stenosis is associated with cognitive decline and dementia, potentially due to cerebral hypoperfusions and microemboli...
Today I will be discussing the presentation that I am discussing at ESC for moderated oral presentation and the topic is neuroprotective effect of aortic valve replacement, a propensity score matched retrospective cohort study. We don’t have any disclosures to disclose and I’m really grateful to all the co-authors involved in preparing this study. Aortic stenosis is associated with cognitive decline and dementia, potentially due to cerebral hypoperfusions and microemboli. Whether an aortic valve replacement confers long-term neuroprotection compared with medical management remains unclear, particularly comparing trans-catheter aortic valve replacement and surgical aortic valve replacement. The purpose of this study was to evaluate the association between aortic valve replacement and long-term risk of dementia subtypes and stroke in a large propensity score matched analysis. So, a retrospective observational cohort study, we have used the TriNetX Global Collaborative Network. Patients with aortic stenosis undergoing aortic valve replacement are compared with those matched medically. Propensity score matching balanced baseline characteristics, comorbidities, medications, and lab parameters, including frailty indicators, sensory impairment, mental health, cardiovascular medications, and prior stroke and TIA. Hazard ratios with 95% confidence intervals were estimated using Cox proportional hazard models for Alzheimer’s disease, vascular dementia, other dementia, unspecified dementia, and mild cognitive impairment, senile degeneration, and cerebral infarction. In the main matched cohort, 159,823 patients per group were included. Aortic valve replacement was associated with reduced risk of Alzheimer’s disease, vascular dementia, other dementias, and unspecified dementia and specified dementias and neurodegeneration. No significant difference was seen for mild cognitive impairment or cerebral infarction. In subgroup analysis, surgical aortic valve replacement showed substantially stronger protection than transcatheter aortic valve replacement across dementia subtypes. Benefits were consistent in both sexes, with slightly higher Alzheimer’s protection in women compared to men, and persisted in patients with prior stroke or TIA. In conclusion, aortic valve replacement is associated with significant long-term reduction in dementia risk across multiple subtypes, independent of early periprocedural effects, with surgical aortic valve replacement demonstrating more pronounced neuroprotective effects than TAVR. These findings support the potential cognitive benefit of valve intervention in aortic stenosis, though residual confounding by disease severity cannot be excluded. And since this is a retrospective study, it is considered to be hypothesis-generating rather than a definitive conclusion.
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Today I will be discussing the presentation that I am discussing at EEC for moderated oral presentation and the topic is neuroprotective effect of aortic valve replacement, a propensity score matched retrospective cohort study. We don’t have any disclosures to disclose and I’m really grateful to all the co-authors involved in preparing this study. Aortic stenosis is associated with cognitive decline and dementia, potentially due to cerebral hypoperfusions and microemboli. Whether an aortic valve replacement confers long-term neuroprotection compared with medical management remains unclear, particularly comparing trans-catheter aortic valve replacement and surgical aortic valve replacement. The purpose of this study was to evaluate the association between aortic valve replacement and long-term risk of dementia subtypes and stroke in a large propensity score matched analysis. So, a retrospective observational cohort study, we have used the TriNetX Global Collaborative Network. Patients with aortic stenosis undergoing aortic valve replacement are compared with those matched medically. Propensity score matching balanced baseline characteristics, comorbidities, medications, and lab parameters, including frailty indicators, sensory impairment, mental health, cardiovascular medications, and prior stroke and TIA. Hazard ratios with 95% confidence intervals were estimated using Cox proportional hazard models for Alzheimer’s disease, vascular dementia, other dementia, unspecified dementia, and mild cognitive impairment, senile degeneration, and cerebral infarction. In the main matched cohort, 159,823 patients per group were included. Aortic valve replacement was associated with reduced risk of Alzheimer’s disease, vascular dementia, other dementias, and unspecified dementia and specified dementias and neurodegeneration. No significant difference was seen for mild cognitive impairment or cerebral infarction. In subgroup analysis, surgical aortic valve replacement showed substantially stronger protection than transcatheter aortic valve replacement across dementia subtypes. Benefits were consistent in both sexes, with slightly higher Alzheimer’s protection in women compared to men, and persisted in patients with prior stroke or TIA. In conclusion, aortic valve replacement is associated with significant long-term reduction in dementia risk across multiple subtypes, independent of early periprocedural effects, with surgical aortic valve replacement demonstrating more pronounced neuroprotective effects than TAVR. These findings support the potential cognitive benefit of valve intervention in aortic stenosis, though residual confounding by disease severity cannot be excluded. And since this is a retrospective study, it is considered to be hypothesis-generating rather than a definitive conclusion.
This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.
