Meta-Analysis of the Prognostic Significance of Carotid Artery Stenosis in Patients Who Underwent Transcatheter Aortic Valve Implantation

被引：3

作者：

Vella, Agnese ^{[1
,2
]}

Roux, Olivier ^{[3
]}

Antiochos, Panagiotis ^{[4
,5
]}

Monney, Pierre ^{[4
,5
]}

Maurizi, Niccolo ^{[4
,5
]}

Skalidis, Ioannis ^{[4
,5
]}

Fournier, Stephane ^{[4
,5
]}

Eeckhout, Eric ^{[4
,5
]}

Roguelov, Christan ^{[4
,5
]}

Oestreicher, Simon ^{[6
]}

Kirsch, Matthias ^{[7
]}

Muller, Olivier ^{[4
,5
]}

Lu, Henri ^{[4
,5
]}

机构：

[1] Geneva Univ Hosp, Serv Cardiol, Geneva, Switzerland

[2] Univ Geneva, Geneva, Switzerland

[3] Herzzentrum Pk AG, HerzHirslanden Grp, Zurich, Switzerland

[4] Lausanne Univ Hosp, Serv Cardiol, Lausanne, Switzerland

[5] Univ Lausanne, Lausanne, Switzerland

[6] Lausanne Univ Hosp, Serv Internal Med, Lausanne, Switzerland

[7] Lausanne Univ Hosp, Serv Cardiovasc Surg, Lausanne, Switzerland

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2023年 / 200卷

关键词：

END-POINT DEFINITIONS; CEREBROVASCULAR EVENTS; STROKE RISK; REPLACEMENT; DISEASE; PREVALENCE; OUTCOMES; ASSOCIATION; PROTECTION; IMPACT;

D O I：

10.1016/j.amjcard.2023.04.031

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Stroke is a known complication of both transcatheter aortic valve implantation (TAVI) and carotid artery stenosis (CAS). Whether CAS is a predictor of worse prognosis after TAVI is unclear. We performed a meta-analysis to assess the impact of CAS on the inci-dence of neurovascular complications and mortality after TAVI. We searched PubMed/ MEDLINE and EMBASE databases from inception to January 2023. CAS was defined by & GE;50% stenosis of at least 1 carotid artery. Studies comparing CAS versus non-CAS TAVI populations were included. Patients' baseline characteristics and 30-day clinical outcomes were extracted. End points included the 30-day incidence of neurovascular complications (stroke or transient ischemic attack) and 30-day all-cause mortality. We identified six studies, totaling 6,763 patients in the CAS group and 23,861 patients in the non-CAS group. Patients with CAS had a higher prevalence of hypertension, diabetes mellitus, dys-lipidemia, previous myocardial infarction, coronary artery bypass graft, peripheral artery disease, previous neurovascular disease, and chronic kidney disease. There was no signifi-cant difference in the rates of 30-day neurovascular complications between CAS and non-CAS groups (relative risk 1.23, 95% confidence interval 0.63 to 2.40, p = 0.54). CAS was associated with a higher risk of 30-day all-cause mortality (relative risk 1.28, 95% confi-dence interval 1.12 to 1.47, p <0.001), not found in a sensitivity analysis. In conclusion, patients with CAS presented with a significantly higher co-morbidity burden. CAS was not associated with an increased risk of 30-day neurovascular complications. 30-day mor-tality was higher in the CAS group but that may be a surrogate of the heavy co-morbidity burden of patients with CAS.& COPY; 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/ 4.0/) (Am J Cardiol 2023;200:225-231)

引用

页码：225 / 231

页数：7