Mid-term prognostic value of coronary artery disease in patients undergoing transcatheter aortic valve implantation: a meta-analysis of adjusted observational results

Int J Cardiol. 2013 Oct 3;168(3):2528-32. doi: 10.1016/j.ijcard.2013.03.062. Epub 2013 Apr 28.

Abstract

Aims: Coronary artery disease (CAD) negatively affects prognosis in patients undergoing surgical aortic valve replacement, being currently evaluated in the most common used risk score. Our meta-analysis aims to clarify the prognostic role of CAD on mid-term survival in patients undergoing TAVI.

Methods and results: Studies reporting multivariate predictors of adverse outcomes in patients undergoing TAVI were systematically searched for and pooled, when appropriate, using a random-effect method. 960 citations were first screened and finally 7 studies (2472 patients) were included. Diagnosis of CAD was reported in 52%(42-65) of patients and 1169 Edwards SAPIEN and 1303 CoreValve prostheses were implanted. After a median follow up of 452 days (357-585) 24% of patients (19-33) died, and 23 (14-32) for cardiovascular death. At pooled analysis of multivariate approach, diagnosis of coronary artery disease did not increase risk of death (OR 1.0, 95% CI, confidence interval, 0.67-1.50 I(2) 0%).

Conclusion: CAD does not affect mid-term TAVI outcome: this finding should be weighted to accurately evaluate risk and strategies for patients with severe aortic stenosis.

Keywords: CAD; Mid-term outcomes; TAVI.

Publication types

  • Meta-Analysis

MeSH terms

  • Aortic Valve Stenosis / complications*
  • Aortic Valve Stenosis / surgery*
  • Coronary Artery Disease / complications*
  • Humans
  • Observational Studies as Topic
  • Prognosis
  • Time Factors
  • Transcatheter Aortic Valve Replacement*