Evidence map›Paper›PMID 36074270›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2022

Propensity matched comparison of TAVI and SAVR in intermediate-risk patients with severe aortic stenosis and moderate-to-severe chronic kidney disease: a subgroup analysis from the German Aortic Valve Registry.

Silvia Mas-Peiro, Gloria Faerber, Dimitra Bon, Eva Herrmann, Timm Bauer, Sabine Bleiziffer, Raffi Bekeredjian, Andreas Böning, Christian Frerker, Andreas Beckmann and 7 more

Abstract read
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
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

17 authors.

Silvia Mas-PeiroDepartment of Cardiology, University Hospital Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.ORCID http://orcid.org/0000-0002-3828-8180
Gloria FaerberDepartment of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany.
Dimitra BonGerman Center for Cardiovascular Research, DZHK, Partner Site Rhine-Main, Rhine-Main, Germany.
Eva HerrmannGerman Center for Cardiovascular Research, DZHK, Partner Site Rhine-Main, Rhine-Main, Germany.
Timm BauerDepartment of Cardiology, Sana Klinikum Offenbach, Offenbach, Germany.
Sabine BleizifferDepartment of Cardiothoracic Surgery, Heart and Diabetes Center NRW, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany.
Raffi BekeredjianDepartment of Cardiology, Robert-Bosch Hospital, Stuttgart, Germany.
Andreas BöningDepartment of Cardiothoracic Surgery, University Hospital Giessen, Giessen, Germany.
Christian FrerkerDepartment of Internal Medicine III, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Andreas BeckmannGerman Society of Thoracic and Cardiovascular Surgery, Langenbeck-Virchow-Haus, Berlin, Germany.
Helge MöllmannDepartment of Cardiology, St. Johannes Hospital, Dortmund, Germany.
Stephan EnsmingerDepartment of Cardiac and Thoracic Vascular Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany.
Christian W HammGerman Center for Cardiovascular Research, DZHK, Partner Site Rhine-Main, Rhine-Main, Germany.
Friedhelm BeyersdorfDepartment of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, University Hospital Freiburg, Freiburg, Germany.
Stephan Fichtlscherer *Department of Cardiology, University Hospital Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany. stephan.fichtlscherer@kgu.de.
Thomas Walther *German Center for Cardiovascular Research, DZHK, Partner Site Rhine-Main, Rhine-Main, Germany.
GARY-Executive Board

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe compared TAVI vs. SAVR in patients with moderate-to-severe chronic kidney disease (eGFR 15-60 ml/min/1.73 m

backgroundAccording to both ACC/AHA and ESC/EACTS recent guidelines, aortic stenosis may be treated with either transcatheter (TAVI) or surgical (SAVR) aortic valve replacement in a subgroup of patients. A shared therapeutic decision is made by a heart team based on individual factors, including chronic kidney disease (CKD).

methodsData from the large nationwide German Aortic Valve Registry were used. A propensity score method was used to select 704 TAVI and 374 SAVR matched patients. Primary endpoint was 1-year survival. Secondary endpoints were clinical complications, including pacemaker implantation, vascular complications, myocardial infarction, bleeding, and the need for new-onset dialysis.

resultsOne-year survival was similar (HR [95% CI] for TAVI 1.271 [0.795, 2.031], p = 0.316), with no divergence in Kaplan-Meier curves. In spite of post-procedural short-term survival being numerically higher for TAVI patients and 1-year survival being numerically higher for SAVR patients, such differences did not reach statistical significance (96.4% vs. 94.2%, p = 0.199, and 86.2% vs. 81.2%, p = 0.316, respectively). In weighted analyses, pacemaker implantation, vascular complications, and were significantly more common with TAVI; whereas myocardial infarction, bleeding requiring transfusion, and longer ICU-stay and overall hospitalization were higher with SAVR. Temporary dialysis was more common with SAVR (p < 0.0001); however, a probable need for chronic dialysis was rare and similar in both groups.

conclusionBoth TAVI and SAVR led to comparable and excellent results in patients with moderate-to-severe CKD in an intermediate-risk population of patients with symptomatic severe aortic stenosis for whom both therapies could possibly be considered.

Indexed as

Aortic Valve StenosisHeart Valve Prosthesis ImplantationMyocardial InfarctionRenal Insufficiency, ChronicTranscatheter Aortic Valve ReplacementAged, 80 and overAortic ValveHumansRegistriesRisk FactorsTreatment OutcomeAortic stenosisChronic kidney diseaseMortalitySurgical aortic valve replacementTranscatheter aortic valve implantation

Identifiers

PMID36074270
PMCPMC9681690

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.