Kesavan Sankaramangalam , MD 1 , Kinjal Banerjee , MD 1 , Krishna Kandregula , MD 1 , Divyanshu Mohananey , MD 2 , Akhil Parashar , MD 2 , Brandon M. Jones , MD 1 , Yash Jobanputra , MD 1 , Stephanie Mick , MD 3 , Amar Krishnaswamy , MD 1 , Lars G. Svensson , MD 3 , Samir R. Kapadia , MD , 1
11 October 2017
coronary artery disease, meta‐analysis, revascularization, transcatheter aortic valve implantation, transcatheter aortic valve replacement, Aortic Valve Replacement/Transcather Aortic Valve Implantation, Coronary Artery Disease, Percutaneous Coronary Intervention
The impact of coronary artery disease ( CAD) on outcomes after transcatheter aortic valve replacement ( TAVR) is understudied. Literature on the prognostic role of CAD in the survival of patients undergoing TAVR shows conflicting results. This meta‐analysis aims to investigate how CAD impacts patient survival following TAVR.
We completed a comprehensive literature search of Embase, MEDLINE, and the Cochrane Library, and included studies reporting outcome of TAVR based on CAD status of patients for the analysis. From the initial 1631 citations, 15 studies reporting on 8013 patients were analyzed using a random‐effects model. Of the 8013 patients undergoing TAVR, with a median age of 81.3 years (79–85.1 years), 46.6% (40–55.7) were men and 3899 (48.7%) had CAD (ranging from 30.8% to 78.2% in various studies). Overall, 3121 SAPIEN/ SAPIEN XT/ SAPIEN 3 (39.6%) and 4763 CoreValve (60.4%) prostheses were implanted, with transfemoral access being the most frequently used approach for the implantation (76.1%). Our analysis showed no significant difference between patients with and without CAD for all‐cause mortality at 30 days post TAVR, with a cumulative odds ratio of 1.07 (95% confidence interval, 0.82–1.40; P=0.62). However, there was a significant increase in all‐cause mortality at 1 year in the CAD group compared with patients without CAD, with a cumulative odds ratio of 1.21 (95% confidence interval, 1.07–1.36; P=0.002).