1. Chronic systemic glucocorticoid therapy is associated with increased risk of major vascular complications and cardiac tamponade after transcatheter aortic valve implantation: a systematic review and meta-analysis.
- Author
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Chiabrando JG, Lombardi M, Seropian IM, Valle Raleigh JM, Vergallo R, Larribau M, Agatiello CR, Trani C, and Burzotta F
- Subjects
- Humans, Postoperative Complications etiology, Postoperative Complications epidemiology, Aortic Valve Stenosis surgery, Risk Factors, Vascular Diseases etiology, Vascular Diseases epidemiology, Cardiac Tamponade etiology, Cardiac Tamponade epidemiology, Transcatheter Aortic Valve Replacement adverse effects, Glucocorticoids adverse effects, Glucocorticoids therapeutic use, Glucocorticoids administration & dosage
- Abstract
Introduction: TAVI-related complications, such as conduction disturbances, vascular complications or death may be related to increased inflammatory response. The aim of this study was to elucidate the efficacy and safety of the systemic glucocorticoid therapy regarding the adverse events after TAVI deployment., Evidence Acquisition: We conducted a systemic search of PubMed, a reference list of relevant articles, and Medline. The main efficacy outcomes of interest were all-cause death, cardiac and non-cardiac death, permanent pacemaker implantation (PPM), new left bundle branch block (LBBB), stroke, and myocardial infarction (MI). Safety endpoints were major vascular complications, major bleeding events, and cardiac tamponade., Evidence Synthesis: A total of 7 studies including data from 3439 patients with a median follow-up was 30 days. Systemic glucocorticoid compared to the control group were associated with an increased risk of non-cardiac death (Relative Risk [RR] 5.90 95%CI [2.95; 11.80], P<0.001) major vascular complications (RR 1.78, 95%CI [1.22 - 2.61], P=0.003) and cardiac tamponade (RR 3.42, 95%CI [1.69 - 6.92], P<0.001). However, there were no differences in all-cause death, cardiac death, new LBBB, stroke, MI, or major bleeding events (all P values >0.05)., Conclusions: Glucocorticoid therapy before the TAVI procedure was associated with an increase in non-cardiac death, major vascular events and cardiac tamponade. There were no differences in the risk of all-cause death, cardiac death, PPM or LBBB, stroke, or MI.
- Published
- 2024
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