TAVR Associated With Cognitive Improvements

HealthDay News – Transcatheter aortic valve replacement (TAVR) is associated with global improvement in cognitive status, according to a study published in the Journal of the American College of Cardiology.

Vincent Auffret, MD, from Laval University in Quebec City, and colleagues evaluated changes in global cognition and specific cognitive domains up to 1 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% of patients were considered cognitively impaired. At short-term (3 months) post-TAVR, the mean total MoCA score improved, and remained stable at 1 year (P =.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 1 year in 1 patient (2%). Cognitive improvement at 1 year was seen in 4 patients (7.8%), increasing to 15% 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 1 test at 30 days on the basis of the RCI; this persisted in 4 patients at 1 year (10%).

“TAVR was associated with global improvement in cognitive status, more pronounced among those with cognitive impairment pre-TAVR,” the authors wrote.

Disclosures: Several authors disclosed financial ties to the pharmaceutical and medical device industries.

References

1. Auffret V, Campelo-Parada F, Reguerio A, et al. Serial changes in cognitive function following transcatheter aortic valve replacement. J Am Coll Cardiol. 2016;68(20):2129-2141. doi:10.1016/j.jacc.2016.08.046.
2. Genereux P. Can TAVR make me smarter? J Am Coll Cardiol. 2016;68(20):2142-2143. doi:10.1016/j.jacc.2016.09.001.