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Sá, Michel Pompeu; Jacquemyn, Xander; Van den Eynde, Jef; Serna-Gallegos, Derek; Chu, Danny; Clavel, Marie-Annick; Pibarot, Philippe; Sultan, Ibrahim
Journal of the American Heart Association, 11/2023, Letnik: 12, Številka: 21Journal Article
Background We performed a meta-analysis of reconstructed time-to-event data from randomized controlled trials (RCTs) and propensity-score matched (PSM) studies comparing transcatheter versus surgical aortic valve replacement (TAVR versus SAVR) to evaluate midterm outcomes in patients considered low risk for SAVR. Methods and Results Study-level meta-analysis of reconstructed time-to-event data from Kaplan-Meier curves of RCTs and PSM studies published by December 31, 2022 was conducted. Eight studies (3 RCTs, 5 PSM studies) met our eligibility criteria and included 5444 patients; 2639 patients underwent TAVR, and 2805 patients underwent SAVR. TAVR showed a higher risk of all-cause mortality at 8 years of follow-up (hazard ratio HR 1.22, 95% CI, 1.03-1.43, =0.018). Up to 2 years of follow-up, TAVR was not inferior to SAVR (HR, 1.08 95% CI, 0.89-1.31, =0.448); however, we observed a statistically significant difference after 2 years with higher mortality with TAVR (HR, 1.51 95% CI, 1.14-2.00; =0.004). This difference was driven by PSM studies; our sensitivity analysis showed a statistically significant difference between TAVR and SAVR when we included only PSM studies (HR, 1.41 95% CI, 1.16-1.72, =0.001) but no statistically significant difference when we included only RCTs (HR, 0.89 95% CI, 0.69-1.16, =0.398). Conclusions In comparison with TAVR, SAVR appeared to be associated with improved survival beyond 2 years in low-risk patients. However, the survival benefit of SAVR was observed only in PSM studies and not in RCTs. The addition of data from ongoing RCTs as well as longer follow-up in previous RCTs will help to confirm if there is a difference in mid- and long-term survival between TAVR versus SAVR in the low-risk population.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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