Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > The Journal of Cardiovascular Surgery 2020 February;61(1) > The Journal of Cardiovascular Surgery 2020 February;61(1):98-106

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

REVIEW  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2020 February;61(1):98-106

DOI: 10.23736/S0021-9509.19.11023-3

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Meta-analysis of impact of troponins on mortality after transcatheter aortic valve implantation

Hisato TAKAGI 1, 2 , Yosuke HARI 1, 2, Kouki NAKASHIMA 1, 2, Toshiki KUNO 3, Tomo ANDO 4, on behalf of the All-Literature Investigation of Cardiovascular Evidence (ALICE) Group

1 Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan; 2 Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan; 3 Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, USA; 4 Department of Cardiology, Detroit Medical Center, Detroit, MI, USA



INTRODUCTION: To determine whether troponin (Tn) can predict mortality after transcatheter aortic valve implantation (TAVI), we performed a meta-analysis of currently available studies investigating impact of baseline and postprocedural Tn.
EVIDENCE ACQUISITION: MEDLINE and EMBASE were searched through April 2019 using PubMed and OVID. Studies considered for inclusion met the following criteria: the study investigating impact of baseline and postprocedural Tn on mortality; the study population was patients undergoing TAVI for aortic stenosis (AS); outcomes included early (30-day or in-hospital)/late (including early) mortality. For each study, data regarding early/late mortality in both high and low (defined in each study) level of baseline/postprocedural Tn groups were used to generate odds ratios (ORs) and 95% confidence intervals (CIs), or reported ORs and hazard ratios (HRs) with 95% CIs were directly extracted. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic ORs/HRs in the random-effects model.
EVIDENCE SYNTHESIS: We identified 19 eligible studies including a total of 7555 patients undergoing TAVI. Pooled analyses demonstrated associations of high levels of baseline Tn with statistically significant increases in both 30-day (P=0.002) and midterm mortality (P<0.00001), no correlation of high postprocedural Tn with 30-day mortality (P=0.13), and an association of high postprocedural Tn with a statistically significant increase in midterm mortality (P=0.002). High levels of baseline/postprocedural TnT predicted statistically significant increases in both 30-day (P=0.002/<0.0001) and midterm mortality (P<0.00001/0.0003).
CONCLUSIONS: Both baseline and postprocedural Tn, especially TnT, may predict mortality after TAVI for AS.


KEY WORDS: Meta-analysis; Mortality; Transcatheter aortic valve replacement; Troponins

inizio pagina