More pronounced improvement in patients with baseline cognitive impairment
TUESDAY, Nov. 29, 2016 (HealthDay News) — Transcatheter aortic valve replacement (TAVR) is associated with global improvement in cognitive status, according to a study published in the Nov. 15 issue of the Journal of the American College of Cardiology.
Vincent Auffret, M.D., from Laval University in Quebec City, and colleagues evaluated changes in global cognition and specific cognitive domains up to one year post-TAVR in 51 patients. Participants underwent TAVR and were prospectively assessed for cognitive function using the Montreal Cognitive Assessment (MoCA).
The researchers found that using a cut-off of >23 of 30 points, 39.2 percent of patients were considered cognitively impaired. At short-term (three months) post-TAVR, the mean total MoCA score improved, and remained stable at one year (P = 0.022). Four patients presented with short-term cognitive decline on the basis of the practice-corrected reliable change index (RCI) of total MoCA score, which persisted at one year in one patient (2.0 percent). Cognitive improvement at one year was seen in four patients (7.8 percent), increasing to 15 percent among those with baseline cognitive impairment. Over time there were no improvements in the digit-symbol substitution test, Trail Making Tests, and verbal fluency test scores. Twenty-five percent of patients presented with a reduction in performance of at least one test at 30 days on the basis of the RCI; this persisted in four patients at one year (10 percent).
“TAVR was associated with global improvement in cognitive status, more pronounced among those with cognitive impairment pre-TAVR,” the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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