Volume 106, Issue 1 pp. 720-729
REVIEW

Impact of Periprocedural Statin Therapy on Mortality and Cardiovascular Outcomes in Transcatheter Aortic Valve Replacement: A Meta-Analysis and Meta-Regression

Aman Goyal

Corresponding Author

Aman Goyal

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA

Correspondence: Aman Goyal ([email protected])

Kamna Bansal ([email protected])

Search for more papers by this author
Surabhi Maheshwari

Surabhi Maheshwari

Department of Internal Medicine, University of Alabama at Montgomery, Montgomery, Alabama, USA

Search for more papers by this author
Yusra Mashkoor

Yusra Mashkoor

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan

Search for more papers by this author
Ajeet Singh

Ajeet Singh

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan

Search for more papers by this author
Faryal Rafique

Faryal Rafique

Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan

Search for more papers by this author
Abu Baker Sheikh

Abu Baker Sheikh

Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA

Search for more papers by this author
Kamna Bansal

Corresponding Author

Kamna Bansal

Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA

Correspondence: Aman Goyal ([email protected])

Kamna Bansal ([email protected])

Search for more papers by this author
First published: 20 May 2025

ABSTRACT

Background

Transcatheter aortic valve replacement (TAVR) stands as a notable alternative to surgical valve replacement for severe aortic stenosis (AS). Despite the established benefits of statins in cardiovascular pathologies, their specific impact in patients with severe AS undergoing TAVR remains uncertain.

Aims

Our meta-analysis aims to assess whether periprocedural statin therapy improves survival and outcomes post-TAVR, thus addressing this gap in literature.

Methods

A comprehensive literature search using various databases with relevant keywords terms was conducted to identify studies on the impact of periprocedural statin therapy on TAVR outcomes. We assessed the primary outcome of all-cause mortality alongside various secondary outcomes including stroke/transient ischemic attack (TIA), myocardial infarction, acute kidney injury (AKI), 30-day mortality, in-hospital mortality, rehospitalization, cardiovascular complications, and pacemaker requirement. A random-effects model using Comprehensive Meta Analysis Software was employed to analyze the data for each outcome. Statistical significance was set at a p < 0.05.

Results

Our analysis of 19 observational studies revealed that periprocedural statin therapy significantly reduces all-cause mortality following TAVR surgery (OR = 0.71, 95% CI: 0.61−0.83, p < 0.001). However, the influence of statins on other outcomes remains inconclusive. These outcomes include stroke/TIA (OR = 0.90, 95% CI: 0.68−1.19, p = 0.455), risk of MI (OR = 1.72, 95% CI: 0.73−4.04, p = 0.214), AKI (OR = 0.99, 95% CI: 0.75−1.31, p = 0.968), 30-day mortality (OR = 0.71, 95% CI: 0.46−1.10, p = 0.126), in-hospital mortality (OR = 0.42, 95% CI: 0.13−1.38, p = 0.151), rehospitalization (OR = 0.92, 95% CI: 0.66−1.29, p = 0.645), cardiovascular complications (OR = 1.12, 95% CI: 0.91−1.37, p = 0.297), and pacemaker requirement (OR = 0.83, 95% CI: 0.65−1.06, p = 0.133).

Conclusion

Our meta-analysis indicates a potentially promising role for periprocedural statin therapy in enhancing patient outcomes post-TAVR surgery. We found a notable association between statin therapy and a reduction in all-cause mortality. However, the effects on secondary outcomes did not reach statistical significance, which warrants further investigation through larger, well-designed, randomized controlled trials.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.