Effect of pulmonary hypertension on the prognosis of patients with severe aortic stenosis after transcatheter aortic valve replacement: A systematic review and meta-analysis
10.7507/1007-4848.202307008
- VernacularTitle:肺动脉高压对重度主动脉瓣狭窄患者经导管主动脉瓣置换术预后影响的系统评价与Meta分析
- Author:
Zhili WEI
1
;
Yang CHEN
1
;
Shuai DONG
2
;
Hao CHEN
1
;
Yang CHEN
2
;
Zhijing AN
2
;
Yalan ZHANG
2
;
Bing SONG
2
Author Information
1. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P. R. China
2. Department of Cardiovascular Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, P. R. China
- Publication Type:Journal Article
- Keywords:
Aortic stenosis;
pulmonary hypertension;
transcatheter aortic valve replacement;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(08):1173-1180
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the impact of pulmonary hypertension (PH) on the prognosis of patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). Methods A computerized search was conducted in CNKI, Wanfang Data, VIP, CBM, PubMed, The Cochrane Library, EMbase, and Web of Science databases from inception to June 2023 for cohort studies on the prognostic impact of PH in severe AS patients undergoing TAVR. Two researchers independently screened the literature, extracted data, and assessed the quality of included studies. Stata 17.0 software was used for meta-analysis. Results A total of 16 cohort studies were included, all with Newcastle-Ottawa Scale scores≥7. Meta-analysis results showed that, compared with AS patients without PH, those with PH had significantly higher 1-year all-cause mortality after TAVR [OR=2.10, 95%CI (1.60, 2.75), P<0.01], 30-day all-cause mortality [OR=2.09, 95%CI (1.54, 2.83), P<0.01], and cardiovascular mortality [OR=1.49, 95%CI (1.18, 1.90), P<0.01]. The differences between the two groups in major bleeding events, stroke, myocardial infarction, pacemaker implantation, and postoperative renal failure were not statistically significant. For outcome indicators with significant heterogeneity, subgroup analyses were performed based on PH measurement methods, diagnostic criteria, and different types of PH. The results showed that most subgroup combined results were consistent with the overall findings and that heterogeneity was significantly reduced. Conclusion PH significantly increases the 30-day all-cause mortality, 1-year all-cause mortality, and cardiovascular mortality in patients with severe AS undergoing TAVR.
