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Clinical Outcomes After Transcatheter Aortic Valve Replacement Using Valve Academic Research Consortium Definitions: A Weighted Meta-Analysis of 3,519 Patients From 16 Studies

Journal of the American College of Cardiology, 2012-06, Vol.59 (25), p.2317-2326 [Peer Reviewed Journal]

2015 INIST-CNRS ;Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2012.02.022 ;PMID: 22503058 ;CODEN: JACCDI

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Title:
Clinical Outcomes After Transcatheter Aortic Valve Replacement Using Valve Academic Research Consortium Definitions: A Weighted Meta-Analysis of 3,519 Patients From 16 Studies
Author: GENEREUX, Philippe ; HEAD, Stuart J ; VAN MIEGHEM, Nicolas M ; KODALI, Susheel ; KIRTANE, Ajay J ; KE XU ; SMITH, Craig ; SERRUYS, Patrick W ; KAPPETEIN, A. Pieter ; LEON, Martin B
Subjects: Aortic Valve - surgery ; Aortic Valve Stenosis - mortality ; Aortic Valve Stenosis - surgery ; Biological and medical sciences ; Cardiac Catheterization - adverse effects ; Cardiac Catheterization - mortality ; Cardiology. Vascular system ; Confounding Factors (Epidemiology) ; Heart Valve Prosthesis - adverse effects ; Heart Valve Prosthesis Implantation - adverse effects ; Heart Valve Prosthesis Implantation - mortality ; Humans ; Incidence ; Medical sciences ; Myocardial Infarction - epidemiology ; Myocardial Infarction - etiology ; Pacemaker, Artificial - statistics & numerical data ; Stroke - epidemiology ; Stroke - etiology ; Survival Analysis ; Survival Rate ; Time Factors ; Treatment Outcome
Is Part Of: Journal of the American College of Cardiology, 2012-06, Vol.59 (25), p.2317-2326
Description: This study sought to perform a weighted meta-analysis to determine the rates of major outcomes after transcatheter aortic valve replacement (TAVR) using Valve Academic Research Consortium (VARC) definitions and to evaluate their current use in the literature. Recently, the published VARC definitions have helped to add uniformity to reporting outcomes after TAVR. A comprehensive search of multiple electronic databases from January 1, 2011, through October 12, 2011, was conducted using predefined criteria. We included studies reporting at least 1 outcome using VARC definitions. A total of 16 studies including 3,519 patients met inclusion criteria and were included in the analysis. The pooled estimate rates of outcomes were determined according to VARC's definitions: device success, 92.1% (95% confidence interval [CI]: 88.7% to 95.5%); all-cause 30-day mortality, 7.8% (95% CI: 5.5% to 11.1%); myocardial infarction, 1.1% (95% CI: 0.2% to 2.0%); acute kidney injury stage II/III, 7.5% (95% CI: 5.1% to 11.4%); life-threatening bleeding, 15.6% (95% CI: 11.7% to 20.7%); major vascular complications, 11.9% (95% CI: 8.6% to 16.4%); major stroke, 3.2% (95% CI: 2.1% to 4.8%); and new permanent pacemaker implantation, 13.9% (95% CI: 10.6% to 18.9%). Medtronic CoreValve prosthesis use was associated with a significant higher rate of new permanent pacemaker implantation compared with the Edwards prosthesis (28.9% [95% CI: 23.0% to 36.0%] vs. 4.9% [95% CI: 3.9% to 6.2%], p < 0.0001). The 30-day safety composite endpoint rate was 32.7% (95% CI: 27.5% to 38.8%) and the 1-year total mortality rate was 22.1% (95% CI: 17.9% to 26.9%). VARC definitions have already been used by the TAVR clinical research community, establishing a new standard for reporting clinical outcomes. Future revisions of the VARC definitions are needed based on evolving TAVR clinical experiences.
Publisher: New York, NY: Elsevier
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2012.02.022
PMID: 22503058
CODEN: JACCDI
Source: GFMER Free Medical Journals
MEDLINE
Alma/SFX Local Collection

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Clinical Outcomes After Transcatheter Aortic Valve Replacement Using Valve Academic Research Consortium Definitions: A Weighted Meta-Analysis of 3,519 Patients From 16 Studies

2015 INIST-CNRS ;Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2012.02.022 ;PMID: 22503058 ;CODEN: JACCDI

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