Evidence map›Paper›PMID 31863174›Full record

SynthesisClinical research in cardiology : official journal of the German Cardiac Society2020

Transcatheter versus surgical aortic valve replacement in low-risk patients: a meta-analysis of randomized trials.

Felix Hofer, Christian Hengstenberg, Georg Goliasch, Marek Grygier, Julia Mascherbauer, Jolanta M Siller-Matula

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Clinical research in cardiology : official journal of the German Cardiac Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Metabolomic profiling of patients with high gradient aortic stenosis undergoing transcatheter aortic valve replacement.Clinical research in cardiology : official journal of the German Cardiac Society · 2021
    Article
  5. Kidney injury as post-interventional complication of TAVI.Clinical research in cardiology : official journal of the German Cardiac Society · 2021
    Review
  6. Prognostic impact of cancer history in patients undergoing transcatheter aortic valve implantation.Clinical research in cardiology : official journal of the German Cardiac Society · 2020
    Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Felix HoferDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0002-0185-7511
Christian HengstenbergDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
Georg GoliaschDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
Marek Grygier1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.
Julia MascherbauerDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
Jolanta M Siller-MatulaDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. Jolanta.siller-matula@meduniwien.ac.at.
Medical University of Vienna · ATMedical University of Warsaw · PLPoznan University of Medical Sciences · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranscatheter aortic valve replacement (TAVR) has emerged as a treatment option for severe aortic stenosis in patients at intermediate or high surgical risk. However, until recently there was insufficient evidence regarding the outcomes of TAVR compared to surgical aortic valve replacement (SAVR) for patients at low risk.

methodsWe conducted a meta-analysis and systematic review of all randomized trials comparing the efficacy and safety of TAVR versus SAVR in patients at low surgical risk. Risk ratios (RR) and 95% confidence intervals (CIs) were calculated, using fixed- or random-effects model.

resultsFour trials were eligible for analysis and comprised a total of 2887 patients (1497 allocated to TAVR and 1390 allocated to SAVR group). TAVR was associated with a 39% relative risk reduction (RRR) of major adverse cardiac events (MACE) (absolute risk reduction ARR of 3.7%; RR 0.61; 95% CI 0.47-0.79); 39% RRR of overall mortality (ARR of 1.4%; RR 0.61; 95% CI 0.39-0.96) and 45% RRR of cardiovascular mortality (ARR of 1.3%; RR 0.55; 95% CI 0.33-0.90), 69% RRR of life threatening or disabling bleeding (ARR of 7.0%; RR 0.31; 95% CI 0.22-0.44), 73% RRR of new-onset atrial fibrillation (ARR of 29%; RR 0.27; 95% CI 0.20-0.35) and 73% RRR of acute kidney injury (ARR of 2.1%; RR 0.27; 95% CI 0.14-0.56) as compared with SAVR. In contrast, TAVR was associated with a 4.7-fold increased risk of new pacemaker (PM) implantation (RR 4.72; 95% CI 1.83-12.15), which was driven by use of self-expanding valves.

conclusionTAVR in low-risk patients is superior to SAVR for the majority of outcomes.

Indexed as

Heart Valve ProsthesisRandomized Controlled Trials as TopicAortic Valve StenosisFluoroscopyHeart Valve Prosthesis ImplantationHumansSeverity of Illness IndexTranscatheter Aortic Valve ReplacementAortic stenosisLow surgical riskSAVRTAVR

Identifiers

PMID31863174
OpenAlexW2994855437

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.