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Outcomes of Evolut R Versus CoreValve After Transcatheter Aortic Valve Implantation: A Meta-Analysis
- Source :
- Heart, lungcirculation. 29(2)
- Publication Year :
- 2018
-
Abstract
- Background Superiority of the new-generation, self-expanding Evolut R compared with the first-generation CoreValve on outcomes after transcatheter aortic valve implantation (TAVI) is unclear. This meta-analysis sought to investigate the outcomes of Evolut R vs CoreValve after TAVI. Methods A systematic review of studies comparing outcomes of Evolut R and CoreValve after TAVI was performed through PubMed, EMBASE and Cochrane Library. Crude risk ratios (RRs) were calculated with 95% confidence intervals using a random effects model. Outcomes of interest were mortality, myocardial infarction (MI), stroke or transient ischaemic attack (TIA), severe bleeding, acute kidney injury (AKI), major vascular complications (MVC), permanent pacemaker implantation (PPI), moderate or severe paravalvular regurgitation (PVR), and device failure. Results Six studies involving 11,530 patients (4,597 receiving Evolut R and 6,933 receiving CoreValve) were included. There was no significant difference in 30-day all-cause mortality between Evolut R and CoreValve (3.4% vs 5.0%, p = 0.10). The incidence of MI (0.2% vs 0.5%, p = 0.02), AKI (6.0% vs 9.2%, p = 0.001), moderate or severe PVR (6.4% vs 8.0%, p = 0.04), and device failure (3.5% vs 5.2%, p = 0.04) were significantly lower in Evolut R than CoreValve. There were trends toward less severe bleeding (7.2% vs 8.8%, p = 0.05) and PPI (18.6% vs 20.8%, p = 0.05) in Evolut R. The rates of stroke or TIA and MVC were similar between the two prostheses. Conclusions Compared with CoreValve, Evolut R did not reduce 30-day all-cause mortality, but significantly improved periprocedural complications after TAVI.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Myocardial Infarction
030204 cardiovascular system & hematology
Cochrane Library
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Risk Factors
Internal medicine
medicine
Humans
030212 general & internal medicine
Myocardial infarction
Stroke
business.industry
Incidence (epidemiology)
Incidence
Acute kidney injury
Acute Kidney Injury
medicine.disease
Confidence interval
Ischemic Attack, Transient
Meta-analysis
Relative risk
Heart Valve Prosthesis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 14442892
- Volume :
- 29
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Heart, lungcirculation
- Accession number :
- edsair.doi.dedup.....82b82962758751316e5d74b04bdd0136