Outcomes after transcatheter aortic valve replacement in cancer survivors with prior chest radiation therapy: an updated systematic review and meta-analysis.

Autor: Yasmin F; Yale University School of Medicine, New Haven, CT, 06511, USA. farah.yasmin@yale.edu.; Yale School of Medicine, New Haven, CT, 06511, USA. farah.yasmin@yale.edu., Moeed A; Dow University of Health Sciences, Karachi, PK, Pakistan., Alam MT; Dow University of Health Sciences, Karachi, PK, Pakistan., Virwani V; Aga Khan University Hospital, Karachi, 74800, Pakistan., Khabir Y; Dow University of Health Sciences, Karachi, PK, Pakistan., Shaikh A; Aga Khan University Hospital, Karachi, 74800, Pakistan., Vyas AV; Lehigh Valley Heart and Vascular Institute, Allentown, PA, USA., Alraies MC; Detroit Medical Center, Detroit, MI, USA.
Jazyk: angličtina
Zdroj: Cardio-oncology (London, England) [Cardiooncology] 2024 Sep 12; Vol. 10 (1), pp. 61. Date of Electronic Publication: 2024 Sep 12.
DOI: 10.1186/s40959-024-00265-7
Abstrakt: Clinical outcomes for TAVR in cancer survivors with prior chest radiation therapy (C-XRT) who develop symptomatic aortic-valve stenosis are not adequately assessed in major clinical trials leading to conflicting results. Hence, we conducted this meta-analysis to evaluate the, safety, efficacy, and mortality outcomes of cancer survivors with prior C-XRT undergoing TAVR. MEDLINE and Scopus were searched up to March 2024. Observational studies and randomized controlled trials comparing severe aortic stenosis patients with and without prior C-XRT undergoing TAVR with at least one outcome of interest were shortlisted. Data were analyzed using random-effects model to derive weighted mean differences, and risk ratios with 95% confidence intervals. Six studies with 6,191 patients (278 C-XRT and 5,913 no-C-XRT) were included. All-cause mortality at 30-day (RR 1.63, p = 0.12) and 1-year interval (RR 1.59, p = 0.08) showed no significant differences with prior C-XRT versus no-C-XRT. Worsening CHF was the only post-procedural safety outcome significantly higher in patients with prior C-XRT (RR 1.98, p = 0.0004) versus no- C-XRT. The efficacy end-points i.e., improvement in LVEF (MD 1.24; -0.50, 2.98), and aortic valve gradient (MD -0.63; -1.32, 0.05) were not significantly different. TAVR has similar all-cause mortality, efficacy and safety (except CHF worsening) among cancer survivors with and without a prior history of C-XRT.
(© 2024. The Author(s).)
Databáze: MEDLINE
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