Increased mortality after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis and low ejection fraction: A meta-analysis of 6898 patients
| Autor: | Giovanni Esposito, Fernando Scudiero, Maria Angela Losi, Giuseppe Giugliano, Giuseppe Gargiulo, Bruno Trimarco, Anna Sannino, Linda Brevetti, Elena Chiacchio, Eugenio Stabile, Gabriele G. Schiattarella, Cinzia Perrino, Evelina Toscano |
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| Přispěvatelé: | Sannino, Anna, Gargiulo, Giuseppe, Schiattarella, GABRIELE GIACOMO, Brevetti, Linda, Perrino, Cinzia, Stabile, Eugenio, Losi, MARIA ANGELA, Evelina, Toscano, Giugliano, Giuseppe, Fernando, Scudiero, Chiacchio, Elena, Trimarco, Bruno, Esposito, Giovanni |
| Rok vydání: | 2014 |
| Předmět: |
Clinical Trials as Topic
medicine.medical_specialty Ejection fraction Transcatheter aortic business.industry Stroke Volume Aortic Valve Stenosis medicine.disease Severity of Illness Index Confidence interval Surgery Transcatheter Aortic Valve Replacement Stenosis Meta-analysis Internal medicine Cardiology medicine Humans In patient Mortality Cardiology and Cardiovascular Medicine business Cardiovascular mortality |
| Zdroj: | International Journal of Cardiology. 176:32-39 |
| ISSN: | 0167-5273 |
| Popis: | There is conflicting evidence regarding the safety and efficacy of transcatheter aortic valve implantation (TAVI) procedures in patients with severe aortic stenosis and low left ventricular ejection fraction (EF). The primary aim of this study was to determine the impact of TAVI on short- and long-term mortality in patients with low EF (EF50%); the secondary aim was to analyze the impact of TAVI procedure on EF recovery in the same setting of patients.Twenty-six studies enrolling 6898 patients with severe aortic stenosis undergoing TAVI procedure were included in the meta-analysis and analyzed for 30-day, 6-month and 1-year all-cause and cardiovascular mortality; a further meta-analysis was also performed in patients with low EF to assess EF changes post TAVI. In low EF patients, both all-cause and cardiovascular short- and long-term mortality were significantly higher when compared to patients with normal EF (30-day-all-cause mortality: 0.13; 95% confidence interval [CI]: 0.01 to 0.25, I(2)=49.65, Q=21.85; 1-year-all-cause mortality: 0.25; 95% [CI]: 0.16 to 0.34, I(2)=25.57, Q=16.12; 30-day-cardiovascular mortality: 0.03; 95% [CI]: -0.31 to 0.36, I(2)=66.84, Q=6.03; 1-year-cardiovascular mortality: 0.29; 95% [CI]: 0.12 to 0.45, I(2)=0.00, Q=1.88). Nevertheless, in low EF patients TAVI was associated with a significant recovery of EF, which started at discharge and proceeded up to 1-year-follow-up.Patients with low EF severe aortic stenosis have higher mortality following TAVI compared to normal EF patients, despite a significant and sustained improvement in EF. |
| Databáze: | OpenAIRE |
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