Table 3.

Meta-analyses on pre-, intra-, and postprocedural variables for the development of cognitive decline and cognitive improvement following transcatheter aortic valve implantation

Variable	Studies	Time-point of decline	N	OR or MD* (95% CI)	p value	Heterogeneity
Factors associated with cognitive decline
Preprocedural
Age	Ghanem, 2013; Schoenenberger 2016	All	340	1.44* (–2.05–4.92)	0.420	I2 = 48.36, df = 1, p = 0.164
AF	Ghanem, 2013; Lansky, 2015; Schoenenberger, 2016	All	410	1.57 (0.84–2.92)	0.156	I2 = 0, df = 2, p = 0 .374
BMI	Ghanem, 2013; Schoenenberger, 2016	All	340	0.73* (–1.21–2.66)	0.462	I2 = 0, df = 1, p = 0.635
Diabetes	Ghanem, 2013; Schoenenberger, 2016	All	340	0.76 (0.32–1.82)	0.535	I2 = 0, df =1, p = 0.560
Gender	Ghanem, 2013; Schoenenberger, 2016	All	340	1.27 (0.62–2.59)	0.507	I2 = 0, df = 1, p = 0.766
Hypertension	Ghanem, 2013; Schoenenberger, 2016	All	340	1.33 (0.16–10.84)	0.787	I2 = 26.88, df = 1, p = 0.242
Baseline CI	Ghanem, 2013; Schoenenberger, 2016	All	340	0.79 (0.26–2.36)	0.668	I2 = 9.24, df = 1, p = 0.294
Stroke/TIA	Ghanem, 2013; Schoenenberger, 2016	All	340	1.35 (0.48–3.81)	0.568	I2 = 0, df = 1, p = 0.328
Intraprocedural
Cerebral protection device	Haussig, 2016; Lansky, 2015; VanMieghem, 2016	Up to 1-week/discharge	198	0.47 (0.25–0.90)	0.022	I2 = 0, df = 2, p = 0.608
Cerebral protection device	Haussig, 2016; Lansky, 2015	1-month	127	1.00 (0.48–2.07)	0.993	I2 = 0, df = 1, p = 0.336
Postprocedural
Stroke	Ghanem, 2013⁎; Gleason, 2016†; Lansky, 2016‡; Schoenenberger, 2016§	All	325	0.54 (0.11–2.71)	0.452	I2 = 22.02, df = 2, p = 0.277
Factors associated with cognitive improvement
Baseline CI	Auffret, 2016; Schoenenberger, 2016	All	280	14.54 (5.79–36.52)	<0.001	I2 = 0, df = 1, p = 0.357

^⁎No patients had a post-procedure stroke.

^†Any stroke or TIA.

^‡Stroke based on VARC-2 criteria.

^§Stroke/MI within 30 days, based on VARC criteria.

AF =atrial fibrillation; BMI = body mass index; CI = cognitive impairment; MD = mean difference; OR = odds ratio; TIA = transient ischemic attack.