EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 2018 02 13() pii EIJ-D-17-00732
Transcatheter aortic valve replacement (TAVR) has become the procedure of choice for inoperable patients and a safe alternative to surgical aortic valve replacement (SAVR) among moderate risk patients. We used meta-analysis to compare the incidence of cerebrovascular events amongst patients undergoing TAVR and SAVR in randomized controlled trials (RCT).
METHODS AND RESULTS
Our search revealed 5 RCTs published between 2011 and 2017 with a total of 5414 patients. Data were summarized as Mantel-Haenszel relative risk (RR) and 95% confidence intervals (CI). The risk of major stroke [RR 0.89 (95% CI 0.53-1.51)], all strokes [RR 0.85(95% 0.59-1.22)] and all cerebrovascular events [RR 0.94 (95% CI 0.75-1.17) was comparable between patients undergoing TAVR and SAVR at 30 days of follow up. The risk of all all strokes [RR 0.92(95% CI 0.69-1.22)], major stroke [RR 0.92(95% CI 0.62-1.37)] and all cerebrovascular events [RR 1.03(95% CI 0.79-1.33)] were comparable between TAVR and SAVR at 1 year of follow up. The incidence of major stroke [RR 1.02 (95% CI 0.64-1.61), all strokes [RR 1.12 (95% CI 0.78-1.62)] and all cerebrovascular events [RR 1.23 (95% CI 0.91-1.66)] was comparable between TAVR and SAVR between 30 days and 1 year of follow-up.
In our meta-analysis of RCTs comparing TAVR and SAVR, we show comparable risk of major stroke, all stroke and all cerebrovascular events.