Surgical Risk Scoring in TAVR: Still Needed? A Metaregression Analysis

被引：5

作者：

Baro, Rocio ^{[1
]}

Cura, Fernando ^{[1
]}

Belardi, Jorge ^{[1
]}

Brugaletta, Salvatore ^{[2
]}

Lamelas, Pablo ^{[1
,3
]}

机构：

[1] Inst Cardiovasc Buenos Aires, Buenos Aires, DF, Argentina

[2] IDIBAPS, Hosp Clin, Clin Cardiovasc Inst, Barcelona, Spain

[3] McMaster Univ, Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

来源：

CURRENT PROBLEMS IN CARDIOLOGY | 2021年 / 46卷 / 12期

关键词：

AORTIC-VALVE-REPLACEMENT; TRANSCATHETER; DURABILITY;

D O I：

10.1016/j.cpcardiol.2021.100875

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Several randomized controlled trials evaluating the effectiveness of transcatheter aortic valve replacement (TAVR) against surgical aortic valve replacement have been published to date. The fact that higher risk populations were implemented first does not necessarily mean that they benefit more from a TAVR procedure. We performed meta-analysis of the 8 randomized clinical trials performing TAVR for both mortality and stroke outcomes. Meta-regression was used to evaluate the association between mean surgical risk using the Society of Thoracic Surgeons (STS) score and hazard ratio observed in each of the trials. Overall, TAVR was associated with a significant reduction of both mortality and stroke across the whole spectrum of patients enrolled, with no evidence of significant heterogeneity. Meta-regression analysis does not suggest a statistically significant association between STS score and hazard ratio for both mortality and stroke. This observation suggests reconsidering the use of risk scores to prioritize TAVR utilization in higher risk patients, while more focus should be done on patient's life expectancy related to TAVR durability.

引用

页数：7

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