Journal article
Meta-Analysis Comparing Outcomes and Need for Renal Replacement Therapy of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement
The American journal of cardiology, v 122(3), pp 468-476
01 Aug 2018
PMID: 29958709
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Acute kidney injury (AKI) is commonly associated with aortic valve replacement. Surgical aortic valve replacement (SAVR) is a known risk factor for AKI but little is known about the short- and long-term effects of transcatheter aortic valve implantation (TAVI). The purpose of our analysis is to identify the short- and long-term effect of TAVI on renal outcomes. We searched Medline and PUBMED from January 1, 2000 to November 6, 2017 for randomized control trials (RCTs) comparing TAVI to SAVR in patients with severe aortic stenosis. Three hundred sixty-nine trials were identified, 6 RCTs were included in our analysis. RevMan version 5.3 was used for statistical analysis. Heterogeneity is calculated using I2 statistics. Primary outcomes were AKI within 30 days and 1 year of TAVI, and requirement for renal replacement therapy. We included 5,536 patients (2,796 in TAVI and 2,740 in SAVR arm) from 6 RCTs. Baseline characteristics were similar. There was reduced incidence of AKI at 30 days of TAVI compared with SAVR, 57 versus 133 (odds ratio [OR] 0.40, confidence interval [CI] 0.28 to 0.56, p <0.00001, I2 = 7%) with no difference at 1 year (OR 0.65, CI 0.32 to 1.32, p = 0.23, I2 = 76%) and need for renal replacement therapy OR 0.95, CI 0.50 to 1.80, p = 0.87, I2 = 0%). Permanent pacemaker was more frequent in the TAVI arm compared with SAVR arm, 379 versus 110, (OR 3.75, CI 1.67 to 8.42, p = 0.001, I2 = 89%). In conclusion, TAVI is associated with a reduction in AKIs at 30 days despite the exposure to contrast and higher incidence of new permanent pacemaker placement.
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Details
- Title
- Meta-Analysis Comparing Outcomes and Need for Renal Replacement Therapy of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement
- Creators
- Waqas Javed Siddiqui - Drexel UniversityChikezie Alvarez - Seton Hall UniversityMuhammad Aslam - Dow University of Health SciencesAbu Bakar - Dow University of Health SciencesMohammad Harisullah Khan - Aga Khan University Medical College, Karachi, PakistanAysha Aslam - Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University, Boston, MassachusettsMuhammad Owais Hanif - Hahnemann University HospitalSyed Farhan Hasni - Hahnemann University HospitalKarthik Ranganna - Hahnemann University HospitalHoward Eisen - Hahnemann University HospitalSandeep Aggarwal - Hahnemann University Hospital
- Publication Details
- The American journal of cardiology, v 122(3), pp 468-476
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); Nephrology (and Hypertension)
- Web of Science ID
- WOS:000447245400015
- Scopus ID
- 2-s2.0-85049047028
- Other Identifier
- 991019168164204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems