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Elvira Manzano, 4 days ago
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Atrial fibrillation tied to mortality, bleeding, stroke after TAVI

03 Oct 2017
In intermediate risk patients, the TAVR is found to have better outcomes

Atrial fibrillation (AF) appears to be linked to poor outcomes following transcatheter aortic valve implantation (TAVI), such as mortality and stroke, according to a new meta-analysis.

Eleven studies (n=11,757) were eligible for inclusion in the meta-analysis, of which seven compared new-onset atrial fibrillation (NOAF) with sinus rhythm populations in terms of mortality. Pairwise meta-analysis showed higher short-term mortality in NOAF (odds ratio [OR], 2.98; p=0.002) and pre-AF (OR, 2.7; p=0.004) than in sinus rhythm patients.

Long-term mortality was also significantly higher in NOAF (OR, 2.3; p<0.0001) and pre-AF (OR, 2.8; p<0.0001) patients.

Similarly, NOAF patients experienced significantly more frequent stroke cases in both short- (OR, 2.1; p<0.0001) and long-term (OR, 1.9; p<0.0001) follow-ups compared with sinus rhythm groups. Strokes were more common in pre-AF patients only in long-term follow-ups (OR, 1.3; p=0.03).

Compared with sinus rhythm groups, bleeding was similarly significantly more common in NOAF patients in short-term follow-up (OR, 1.5; p=0.002) but only marginally significant in long-term follow-ups (OR, 1.27; p=0.07). No significant differences in bleeding was found between sinus rhythm and pre-AF patients.

Similar findings were obtained in the network meta-analysis. Both NOAF and pre-AF were associated with higher mortality at short-term (OR, 2.7; p=0.002 and OR, 2.5; p=0.002, respectively) and long-term (OR, 2.5; p<0.0001 and OR, 2.7; p<0.0001, respectively) follow-ups compared with sinus rhythm.

NOAF significantly increased the rate of stroke both at short- (OR, 2.01; p<0.001) and long-term (OR, 1.59; p=0.01) follow-ups, while the risk of major bleeding was significantly higher only in the short-term follow-ups (OR, 1.54; p=0.003).

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Most Read Articles
Elvira Manzano, 4 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
20 hours ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, 22 hours ago
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.