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Mortality risk after TAVI comparable between patients with tricuspid vs bicuspid aortic valves

11 Jun 2019

The likelihood of postprocedural peacemaker implantation (PMI) and midterm mortality after transcatheter aortic valve implantation (TAVI) is comparable between patients with bicuspid (B-AV) and tricuspid (T-AV) aortic valves, reports a recent meta-analysis.

Researchers accessed the databases of Medline and Embase for studies that compared B-AV and T-AV patients who underwent TAVI. Outcomes included the incidence of postprocedural PMI or transcatheter valve regurgitation (TVR), and early (30-day and in-hospital) or late mortality.

Applying the selection criteria yielded 12 eligible studies with 1,045 B-AV and 4,069 T-AV participants. Compared with T-AV patients, those with B-AV were significantly more likely to develop TVR after TAVI (risk ratio [RR], 1.42, 95 percent CI, 1.11–1.82; Z, 2.76; p=0.006). There was no significant heterogeneity of evidence (p=1.00).

In contrast, the B-AV and T-AV groups were comparable in terms of PMI incidence (RR, 1.07, 0.87–1.32; Z, 0.61; p=0.54), 30-day mortality (RR, 1.35, 0.94–1.93; Z, 1.61; p=0.11) and midterm mortality (1–2-years; RR, 1.00, 0.77–1.31; Z, 0.01; p=0.99).

The researchers then performed meta-regression analysis of six potential confounders: age, B-AV type, mean aortic valve gradient, left ventricular ejection fraction, aortic valve area and aortic valve calcification. All obtained coefficients failed to reach statistical significance, indicating that the effect of B-AV on the outcomes of interest is independent of these confounding factors.

Future meta-analyses that include a larger number of studies of good quality will be helpful in validating the present findings, the researchers said.

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Most Read Articles
6 days ago
In patients with type 2 diabetes, obesity may be protective against vision-threatening diabetic retinopathy, a recent Korea study has shown.
Yesterday
The aromatase inhibitor anastrozole shows promise in the treatment of children with congenital adrenal hyperplasia, reducing bone age advancement without adversely affecting bone mineral density and visceral adipose tissue, as shown in a recent study.
Roshini Claire Anthony, 5 days ago

Men with metastatic hormone-sensitive prostate cancer (mHSPC) who receive testosterone suppression therapy may have a better survival outcome with the addition of enzalutamide over other non-steroidal anti-androgen (NSAA) therapies, according to the phase III ENZAMET* trial.

5 days ago
The use of opioids may have limited long-term efficacy in the management of chronic noncancer pain, reports a new study.