In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
Abstract:
Introduction: With the increasing prevalence of asymptomatic severe AS and its progression to the symptomatic stage the early surgical aortic valve repair is emerging as a popular option but with limited evidence of its efficacy and safety. Objective: We aimed to conduct a meta-analysis to evaluate the efficacy and safety to early surgical aortic valve repair as compared to conservative management. Methods: A systematic literature search was performed in PubMed, Scopus, Embase and Cochrane databases for studies comparing the early surgery versus conservative management among asymptomatic aortic stenosis patients. The primary outcome was all-cause mortality. Secondary endpoints were cardiovascular mortality (CVM), sudden cardiac death (SCD), hospitalisation due to heart failure, the composite of mortality and MACCE, Clinical thromboembolic events, major bleeding, myocardial infarction (MI), and stroke. Results: A total of 5 articles (3 observational studies and 2 randomized controlled trials) were included. We found that there were significantly lower odds of all-cause mortality [OR, 0.33; (95%CI:0.25-0.42); p 〈 0.000001], cardiovascular mortality [OR, 0.34 (95%CI:0.25-0.47); p 〈 0.00001] and composite of mortality and MACE (OR:0.32(95%CI:0.24,0.42;p 〈 0.00001), sudden cardiac death (OR:0.32; CI: 0.16-0.64; p=0.001) and hospitalization due to heart failure (OR:0.27, CI: 0.16-0.44; p 〈 0.00001) with early surgical aortic valve repair compared to conservative management. There was no significant difference between the incidence of major bleeding, clinical thromboembolic events, stroke and myocardial infarction between the conservative care groups and early surgery. We also found a reduced risk of Conclusion: Among asymptomatic patients with AS, SAVR shows better outcomes in reducing mortality and other complications compared with the conservative management approach.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.146.suppl_1.11191
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
1466401-X
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