Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients
Background: It has been proposed that transcatheter aortic valve replacement (TAVR) may be an option for patients with cancer and severe aortic stenosis. We assessed the association between previous or active cancer and clinical outcomes in TAVR patients.Methods: We searched four electronic database...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.763557/full |
| _version_ | 1819035051792269312 |
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| author | Carlos Diaz-Arocutipa Carlos Diaz-Arocutipa Javier Torres-Valencia Javier Torres-Valencia Gabriela Zavaleta-Camacho Gabriela Zavaleta-Camacho Lourdes Vicent Lourdes Vicent |
| author_facet | Carlos Diaz-Arocutipa Carlos Diaz-Arocutipa Javier Torres-Valencia Javier Torres-Valencia Gabriela Zavaleta-Camacho Gabriela Zavaleta-Camacho Lourdes Vicent Lourdes Vicent |
| author_sort | Carlos Diaz-Arocutipa |
| collection | DOAJ |
| description | Background: It has been proposed that transcatheter aortic valve replacement (TAVR) may be an option for patients with cancer and severe aortic stenosis. We assessed the association between previous or active cancer and clinical outcomes in TAVR patients.Methods: We searched four electronic databases from inception to March 05, 2021. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, myocardial infarction, stroke, acute kidney injury, pacemaker implantation, major bleeding, and vascular complications. All meta-analyses were performed using a random-effects model. Relative risks (RRs) and adjusted hazard ratios (aHRs) with their 95% confidence interval (95% CI) were pooled.Results: Thirteen cohort studies involving 255,840 patients were included. The time period for mortality ranged from inpatient to 10 years. Patients with active cancer had a higher risk of all-cause mortality using both crude (RR, 1.46; 95% CI, 1.13–1.88) and adjusted (aHR, 1.79; 95% CI, 1.43–2.25) estimates compared to non-cancer group. In contrast, the risk of cardiovascular mortality (RR, 1.26; 95% CI, 0.58–2.73), myocardial infarction (RR, 0.94; 95% CI, 0.34–2.57), stroke (RR, 0.90; 95% CI, 0.75–1.09), pacemaker implantation (RR, 0.87; 95% CI, 0.50–1.53), acute kidney injury (RR, 0.88; 95% CI, 0.74–1.04), major bleeding (RR, 1.15; 95% CI, 0.80–1.66), and vascular complications (RR, 0.96; 95% CI, 0.79–1.18) was similar between patients with or without cancer.Conclusion: Our review shows that TAVR patients with active cancer had an increased risk of all-cause mortality. No significant association with secondary outcomes was found. |
| first_indexed | 2024-12-21T07:43:29Z |
| format | Article |
| id | doaj.art-fdc2620414ec46d780eb27c92bbd305a |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-21T07:43:29Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-fdc2620414ec46d780eb27c92bbd305a2022-12-21T19:11:16ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-11-01810.3389/fcvm.2021.763557763557Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 PatientsCarlos Diaz-Arocutipa0Carlos Diaz-Arocutipa1Javier Torres-Valencia2Javier Torres-Valencia3Gabriela Zavaleta-Camacho4Gabriela Zavaleta-Camacho5Lourdes Vicent6Lourdes Vicent7Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, PeruPrograma de Atención Domiciliaria – EsSalud, Lima, PeruDepartamento de Cardiología, Hospital Nacional Edgardo Rebagliati Martins, Lima, PeruFacultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, PeruDepartamento de Cardiología, Hospital Nacional Edgardo Rebagliati Martins, Lima, PeruFacultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, PeruCardiology Department, Hospital Universitario 12 de Octubre, Madrid, SpainInstituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, SpainBackground: It has been proposed that transcatheter aortic valve replacement (TAVR) may be an option for patients with cancer and severe aortic stenosis. We assessed the association between previous or active cancer and clinical outcomes in TAVR patients.Methods: We searched four electronic databases from inception to March 05, 2021. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, myocardial infarction, stroke, acute kidney injury, pacemaker implantation, major bleeding, and vascular complications. All meta-analyses were performed using a random-effects model. Relative risks (RRs) and adjusted hazard ratios (aHRs) with their 95% confidence interval (95% CI) were pooled.Results: Thirteen cohort studies involving 255,840 patients were included. The time period for mortality ranged from inpatient to 10 years. Patients with active cancer had a higher risk of all-cause mortality using both crude (RR, 1.46; 95% CI, 1.13–1.88) and adjusted (aHR, 1.79; 95% CI, 1.43–2.25) estimates compared to non-cancer group. In contrast, the risk of cardiovascular mortality (RR, 1.26; 95% CI, 0.58–2.73), myocardial infarction (RR, 0.94; 95% CI, 0.34–2.57), stroke (RR, 0.90; 95% CI, 0.75–1.09), pacemaker implantation (RR, 0.87; 95% CI, 0.50–1.53), acute kidney injury (RR, 0.88; 95% CI, 0.74–1.04), major bleeding (RR, 1.15; 95% CI, 0.80–1.66), and vascular complications (RR, 0.96; 95% CI, 0.79–1.18) was similar between patients with or without cancer.Conclusion: Our review shows that TAVR patients with active cancer had an increased risk of all-cause mortality. No significant association with secondary outcomes was found.https://www.frontiersin.org/articles/10.3389/fcvm.2021.763557/fullaortic stenosisTAVRcancersystematic reviewmortality |
| spellingShingle | Carlos Diaz-Arocutipa Carlos Diaz-Arocutipa Javier Torres-Valencia Javier Torres-Valencia Gabriela Zavaleta-Camacho Gabriela Zavaleta-Camacho Lourdes Vicent Lourdes Vicent Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients Frontiers in Cardiovascular Medicine aortic stenosis TAVR cancer systematic review mortality |
| title | Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients |
| title_full | Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients |
| title_fullStr | Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients |
| title_full_unstemmed | Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients |
| title_short | Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients |
| title_sort | association between previous or active cancer and clinical outcomes in tavr patients a systematic review and meta analysis of 255 840 patients |
| topic | aortic stenosis TAVR cancer systematic review mortality |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.763557/full |
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