TCT-884 Transcatheter Aortic Valve Replacement Outcomes in Patients With Cardiogenic Shock: A Systematic Review and Meta-Analysis
Recommended Citation
Madanat L, Alhuneafat L, Hanson I, Abbas A, Al-Abdouh A, Ayyad M, Obeidat L, Mhanna M, Frisoli T, Alqarqaz M, Villablanca P. TCT-884 Transcatheter Aortic Valve Replacement Outcomes in Patients With Cardiogenic Shock: A Systematic Review and Meta-Analysis. J Am Coll Cardiol 2024; 84(18):B370.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: While transcatheter aortic valve replacement (TAVR) has broadened treatment options for critically ill patients, outcomes among those with concomitant cardiogenic shock (CS) are not well-explored. Methods: We conducted a comprehensive search of major databases for studies comparing outcomes of TAVR in patients with and without CS since inception up to October 31, 2023. Dichotomous outcomes were assessed using the Mantel-Haenszel method (risk ratio, 95% CI), and continuous outcomes were evaluated using mean difference and 95% CI with the inverse variance method. Results: Five studies were included in the final analysis with a total of 26,283 patients. Among the 7,267 (27.6%) patients with CS, 30-day mortality (OR: 3.41; 95% CI: 2.01-5.76; P < 0.01) and 30-day major vascular complications (OR: 1.72; 95% CI: 1.54-1.92; P < 0.01) were higher compared with those without CS. Conversely, 1-year mortality was not significantly different (OR: 2.68; 95% CI: 0.53-13.46, P = 0.12). No significant differences were observed in the likelihood of 30-day aortic valve reintervention (OR: 3.20; 95% CI: 0.63-16.22, P = 0.09) or post-TAVR aortic insufficiency (OR: 0.91; 95% CI: 0.33-2.51, P = 0.73) between both groups. Furthermore, 30-day stroke, pacemaker implantation, and in-hospital major bleeding were similar between both cohorts (Figure 1). Conclusion: Among TAVR patients, short-term mortality is higher in patients with CS. There was no significant difference in 1-year mortality, need for AV reintervention, in-hospital bleeding or 30-day stroke and pacemaker implantation in patients with CS shock compared with patients not in CS. Categories: STRUCTURAL: Valvular Disease: Aortic
Volume
84
Issue
18
First Page
B370
