Clinical outcomes in nonagenarians undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis

AbstractTo compare the risk of procedural complications and mortality after transcatheter aortic valve implantation (TAVI) in nonagenarians (age  ≥ 90 years) compared to younger patients (<  90 years). Although TAVI could be considered as a treatment option in nonagenarians, several previous studies have shown conflicting outcomes between nonagenarians and younger patients who underwent TAVI. We conducted a comprehensive literature search through PubMed and EMBASE to investigate the clinical outcomes of nonagenarians after TAVI. The outcomes of interest were short- and long-term mortality and procedural complications. Our study identified 16 observational studies including a total of 179,565 patients (21,674 nonagenarian patients and 157,891 younger patients. Nonagenarians had a significantly higher rate of short- (hazard ratio [HR], 95% confidence interval [CI]: 1.48, 1.38–1.59;P <  0.001) and long-term mortality (HR, 95% CI: 1.34, 1.24–1.44;P <  0.001) than younger patients after TAVI. Furthermore, there were significant differences in major and/or life-threatening bleeding (risk ratio [RR], 95% CI: 1.21, 1.05–1.39;P = 0.008), stroke (HR, 95% CI: 1.24, 1.11–1.40;P <  0.001), and major vascular complication (RR, 95% CI: 2.15, 1.35–3.42;P = 0.001) between nonagenarians and younger patients after TAVI. Minor vascular complication, myocardial infarction and permanent pacemaker implantation rate were similar between the two gro...
Source: Cardiovascular Intervention and Therapeutics - Category: Cardiology Source Type: research