Evidence map›Paper›PMID 34622437›Full record

SynthesisCardiology journal2023

Transcatheter aortic valve implantation results are not superimposable to surgery in patients with aortic stenosis at low surgical risk.

Maria Cristina Acconcia, Marco Alfonso Perrone, Domenico Sergi, Marco Di Luozzo, Massimo Marchei, Pasquale De Vico, Antonio Sili Scavalli, Giuseppe Pannarale, Marcello Chiocchi, Carlo Gaudio and 3 more

Open access · goldAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cardiology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 80% 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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

13 authors at 3 institutions in 1 country.

Maria Cristina AcconciaDepartment of Cardiovascular Disease, University of Rome La Sapienza, Rome, Italy.
Marco Alfonso PerroneDepartment of Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy. marco.perrone@uniroma2.it.ORCID 0000-0002-0511-2621
Domenico SergiDepartment of Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy.
Marco Di LuozzoDepartment of Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy.
Massimo MarcheiDepartment of Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy.
Pasquale De VicoDepartment of Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy.
Antonio Sili ScavalliDepartment of Cardiovascular Disease, University of Rome La Sapienza, Rome, Italy.
Giuseppe PannaraleDepartment of Cardiovascular Disease, University of Rome La Sapienza, Rome, Italy.
Marcello ChiocchiDepartment of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome Tor Vergata, Rome, Italy.
Carlo GaudioDepartment of Cardiovascular Disease, University of Rome La Sapienza, Rome, Italy.
Francesco RomeoDepartment of Cardiovascular Disease, University of Rome Tor Vergata, Rome, Italy.
Quintilio CarettaDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Francesco BarillàDepartment of Cardiovascular Disease, University of Rome La Sapienza, Rome, Italy.
University of Rome Tor Vergata · ITSapienza University of Rome · ITUniversity of Florence · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this meta-analysis was to compare the impact of transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve replacement (SAVR) in patients with severe aortic valve stenosis (AS) at low surgical risk.

methodsAll randomized controlled trials (RCTs) and observational studies (Obs) published from January 2014 until March 31st, 2020 were retrieved through the PubMed computerized database and at the site https://www. CLINICALTRIALS: com. The relative risk (RR) with the 95% confidence interval (CI) was used to evaluate the effect of the intervention under comparison. The primary endpoints were all-cause 30-day mortality and 1-year mortality. The 30-day safety endpoints were: stroke, acute kidney injury stage 2 or 3, major bleeding, moderate/severe paravalvular leak, need for new permanent pacemaker (PM) implantation.

resultsAfter detailed review 9 studies, related to 4 RCTs and 5 Obs, were selected. The overall analysis of RCTs plus Obs showed a significantly lower 30-day mortality for TAVI (RR = 0.55; 95% CI 0.45-0.68, p < 0.00001; I2 = 0%). However, an increased risk of new PM implantation (RR = 2.87; 95% CI 2.01-3.67, p < 0.00001, I2 = 0%) and of paravalvular leak (RR = 7.28; 95% CI 3.83-13.81, p < 0.00001, I2 = 0%) was observed in TAVI compared to SAVR. On the contrary, a lower incidence of major bleeding (RR = 0.38; 95% CI 0.27-0.54, p < 0.00001, I2 = 0%) and of acute kidney injury was observed (RR = 0.33; 95% CI 0.19-0.56, p < 0.0001, I2 = 0%) in TAVI.

conclusionsTAVI and SVAR in the treatment of AS in the patients at low surgical risk are not superimposable. In particular, if 30-day and 1-year mortality, major bleeding and acute kidney injury were significantly lower for TAVI, the need of new PM implantation and paravalvular leak were significantly lower in SAVR. Consequently, we suggest the need of more trials to evaluate the effectiveness of TAVI as routine therapeutic procedure in the treatment of patients with low surgical risk AS.

Indexed as

Acute Kidney InjuryAortic Valve StenosisHeart Valve Prosthesis ImplantationTranscatheter Aortic Valve ReplacementHemorrhageHumansRisk FactorsTreatment Outcomeaortic stenosislow surgical riskmeta-analysisprosthetic aortic valvestranscatheter aortic valve implantationtranscatheter aortic valve interventions

Identifiers

PMID34622437
PMCPMC10508068
OpenAlexW3201913016

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.