Author + information
- Navkaranbir S. Bajaja,b,
- Garima Aroraa,b,
- Nirav Patela,b,
- Rajat Kalraa,b,
- Shikhar Vohraa,b,
- Amier Ahmada,b and
- Pankaj Aroraa,b
Background: Rates of adverse outcomes in patients undergoing treatment for severe aortic stenosis (AS) utilizing different treatment modalities (DTMs) are not well known. We compared 1-year risk of stroke, permanent pacemaker placement (PPM) and moderate/severe paravalvular aortic insufficiency (PAI) in patients with severe AS treated with DTMs.
Methods: Randomized control trials (RCTs) reporting 1-year adverse outcome rates in patients with severe AS across DTMs were identified using SCOPUS. Network meta-analyses (NMA) using multivariate random effects modeling were conducted to compare DTMs including CoreValve (CV), Edwards Sapien valve (ES), Edwards XT valve (EXT), Surgical aortic valve replacement (SAVR) and Standard medical therapy (SMT). SMT included 57% patients with balloon valvuloplasty.
Results: Seven RCTs with 4,914 patients were included. CV, ES, EXT, SAVR and SMT were studied in 652, 803, 1416, 1864 and 179 patients respectively (Figure, panel A). Higher 1-year stroke risk was observed in ES as compared to CV group (Figure, panel B). We observed higher PAI rates and a trend towards higher 1-year rates of PPM placement in CV group as compared to other modalities. Several of these differences among DTMs were statistically significant (Figure, panel C, D).
Conclusions: Higher 1-year stroke risk was observed in ES as compared to CV. Higher PAI rates and a trend towards higher PPM was seen in CV group as compared to other modalities. RCTs are needed to directly compare DTMs.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: TAVR 3
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1243-192
- 2017 American College of Cardiology Foundation