{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T09:05:45Z","timestamp":1784797545920,"version":"3.55.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">There was limited high\u2010quality evidence that illuminated the efficiency of cerebral embolic protection (CEP) use during transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) stenosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In this retrospective cohort study, patients with BAV stenosis undergoing TAVR with or without CEP were identified by querying the National Inpatient Sample database. The primary end point was any stroke during the hospitalization. The composite safety end point included any in\u2010hospital death and stroke. We applied propensity score\u2013matched analysis to minimize standardized mean differences of baseline variables and compare in\u2010hospital outcomes. From July 2017 to December 2020, 4610 weighted hospitalizations with BAV stenosis undergoing TAVR were identified, of which 795 were treated with CEP. There was a significant increase in the CEP use rate for BAV stenosis (\n              <jats:italic>P<\/jats:italic>\n              \u2010trend &lt;0.001). A total of 795 discharges with CEP use were propensity score matched to 1590 comparable discharges but without CEP. CEP use was associated with a lower incidence of in\u2010hospital stroke (1.3% versus 3.8%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), which in multivariable regression was also independently associated with the primary outcome (adjusted odds ratio=0.38 [95% CI, 0.18\u20130.71];\n              <jats:italic>P<\/jats:italic>\n              =0.005) and the safety end point (adjusted odds ratio=0.41 [95% CI, 0.22\u20130.68]\n              <jats:italic>P<\/jats:italic>\n              =0.001). Meanwhile, no significant difference was found in the cost of hospitalization ($46\u2009629 versus $45\u2009147;\n              <jats:italic>P<\/jats:italic>\n              =0.18) or the risk of vascular complications (1.9% versus 2.5%;\n              <jats:italic>P<\/jats:italic>\n              =0.41).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">This observational study supported CEP use for BAV stenosis, which was independently associated with less in\u2010hospital stroke without burdening the patients with a high hospitalization cost.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028890","type":"journal-article","created":{"date-parts":[[2023,6,11]],"date-time":"2023-06-11T02:24:34Z","timestamp":1686450274000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Outcomes of Cerebral Embolic Protection for Bicuspid Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Replacement"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4419-5359","authenticated-orcid":false,"given":"Jiajun","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Cheeloo College of Medicine Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Qilu Hospital of Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Cardiovascular Remodeling and Function Research Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Cheeloo College of Medicine Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Qilu Hospital of Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Cardiovascular Remodeling and Function Research Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengzhi","family":"Zong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Cheeloo College of Medicine Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Qilu Hospital of Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Cardiovascular Remodeling and Function Research Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinghua","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4670-3727","authenticated-orcid":false,"given":"Feng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Cheeloo College of Medicine Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Qilu Hospital of Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Cardiovascular Remodeling and Function Research Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9501-2546","authenticated-orcid":false,"given":"Yuguo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Cheeloo College of Medicine Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Qilu Hospital of Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Cardiovascular Remodeling and Function Research Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1224-0509","authenticated-orcid":false,"given":"Chuanbao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Cheeloo College of Medicine Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Emergency and Critical Care Medicine of Shandong Province Qilu Hospital of Shandong University Jinan Shandong China"},{"name":"Key Laboratory of Cardiovascular Remodeling and Function Research Qilu Hospital of Shandong University Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.2695"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.7525"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.11.011"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.10302"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv191"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204961"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.023"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-20-00744"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.07.052"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.7108"},{"key":"e_1_3_2_14_2","volume-title":"The National (Nationwide) Inpatient Sample Database Documentation","author":"Healthcare Cost and Utilization Project","year":"2022","unstructured":"Healthcare Cost and Utilization Project . Introduction to the HCUP National Inpatient Sample (NIS). The National (Nationwide) Inpatient Sample Database Documentation. Agency for Healthcare Research and Quality; 2022. Available at: https:\/\/hcup\u2010us.ahrq.gov\/db\/nation\/nis\/nisdbdocumentation.jsp"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.05.039"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.06.037"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2021.04.038"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.01.007"},{"key":"e_1_3_2_19_2","volume-title":"HCUP Cost\u2010to\u2010Charge Ratio Methodologies","author":"Pickens GT","year":"2021","unstructured":"Pickens GT, Liang L, Roemer M. HCUP Cost\u2010to\u2010Charge Ratio Methodologies. Agency for Healthcare Research and Quality; 2021. HCUP methods series report # 2021\u201005 ONLINE. December 17, 2021. http:\/\/www.hcup\u2010us.ahrq.gov\/reports\/methods\/methods.jsp"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.06.018"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2021.04.006"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV12I4A84"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.605"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab002"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0000000000001413"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-21-00757"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.6767"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.122.028890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:45:35Z","timestamp":1715604335000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.122.028890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,20]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,6,20]]}},"alternative-id":["10.1161\/JAHA.122.028890"],"URL":"https:\/\/doi.org\/10.1161\/jaha.122.028890","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,20]]},"assertion":[{"value":"2023-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e028890"}}