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Clinical Efficacy and Safety of Evolocumab in High-Risk Patients Receiving a Statin: Secondary Analysis of Patients With Low LDL Cholesterol Levels and in Those Already Receiving a Maximal-Potency Statin in a Randomized Clinical Trial Role of Low Endothelial Shear Stress and Plaque Characteristics in the Prediction of Nonculprit Major Adverse Cardiac Events: The PROSPECT Study Lack of Association Between Heart Failure and Incident Cancer Patient Characteristics Associated With Antianginal Medication Escalation and De-Escalation Following Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the OPEN CTO Registry A Combination of Allogeneic Stem Cells Promotes Cardiac Regeneration Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major Cardiovascular Events Among Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Clinical Trial Relations between implementation of new treatments and improved outcomes in patients with non-ST-elevation myocardial infarction during the last 20 years: experiences from SWEDEHEART registry 1995 to 2014 Clinical and Angiographic Features of Patients With Out-of-Hospital Cardiac Arrest and Acute Myocardial Infarction The Potential Use of the Index of Microcirculatory Resistance to Guide Stratification of Patients for Adjunctive Therapy in Acute Myocardial Infarction Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association
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Review Article2019 May 25. pii: S0002-9149(19)30584-3.

JOURNAL：Am J Cardiol. Article Link

Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort

Ando T, Ashraf S, Villablanca P et al. Keywords: transcatheter aortic valve implantation; surgical aortic valve replacement; low-to-intermediate surgical risk cohort

ABSTRACT

Transcatheter aortic valve implantation (TAVI) has been used to treat high surgical risk cohorts but has been expanded to treat low-to-intermediate risk cohort as well. We performed a systematic review and meta-analysis to compare the outcomes between TAVI and surgical aortic valve replacement (SAVR) in low-to-intermediate risk cohort. We queried PUBMED, EMBASE, and ClinicalTrial.gov for relevant articles. Randomized controlled trials that compared at least one of the outcomes of interest between TAVI and SAVR were included. Risk ratio (RR) and 95% confidence interval (CI) were pooled with a random-effects model to compare the risk of the primary outcome between the 2 procedures. The primary outcome was a composite of all-cause mortality or disabling/major stroke at 1 year. Seven studies with a total of 7,143 patients (3,665 TAVI) were included. All-cause mortality or disabling/major stroke at 30 days (6 studies, RR 0.71, 95% CI 0.49 to 1.03) was similar between TAVI and SAVR but was significantly lower in TAVI at 1 year (5 studies, RR 0.81, 95% CI 0.67 to 0.98). All-cause mortality was similar at both 30 days (7 studies, RR 0.90, 95% CI 0.67 to 1.21) and 1 year (6 studies, RR 0.89, 95% CI 0.76 to 1.04). Disabling/major stroke was similar between the 2 procedures (6 studies, RR 0.69, 95% CI 0.42 to 1.12) at 30 days but was significantly lower in TAVI at 1 year (5 studies RR 0.71, 95% CI 0.51 to 0.98). Age, gender, diabetes, and surgical risk score did not modulate the primary outcome. TAVI had a significantly lower composite of all-cause mortality or disabling/major stroke at 1 year compared with SAVR in low-to-intermediate surgical risk cohort.

Copyright © 2019 Elsevier Inc. All rights reserved.

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