Stroke remains a recognized complication of transcatheter aortic valve replacement (TAVR), but its effect on long-term cognition remains uncertain. A large cohort study using the TriNetX Analytics Network (2010–2025), published in the International Journal of Cardiology, evaluated the association between post-TAVR stroke and subsequent development of vascular dementia and mild cognitive impairment.

The analysis included 57,506 patients aged 65 years or older who underwent TAVR. The analysis compared 2,662 patients with post-TAVR stroke to 2,662 without stroke after propensity score matching. At one year, vascular dementia occurred in 3.1% of patients with stroke versus 2.4% without stroke (adjusted HR 1.29; 95% CI 0.92–1.81; p = 0.137). This difference diminished at three years (4.5% vs 4.1%; HR 1.09; p = 0.511) and five years (5.3% vs 4.9%; HR 1.09; p = 0.456). Mild cognitive impairment rates remained similar across groups at all time points. Predictors of cognitive decline included age (HR 1.08 per year), anticoagulation use (HR 1.63), and chronic kidney disease (HR 1.35).

The study concluded that post-TAVR stroke modestly affects early cognitive outcomes, but traditional cardiovascular risk factors play a larger role in long-term cognitive decline. These findings highlight the importance of managing modifiable risk factors in post-TAVR care.