Impact of Periprocedural Statin Therapy on Mortality and Cardiovascular Outcomes in Transcatheter Aortic Valve Replacement: A Meta-Analysis and Meta-Regression
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 authorSurabhi Maheshwari
Department of Internal Medicine, University of Alabama at Montgomery, Montgomery, Alabama, USA
Search for more papers by this authorYusra Mashkoor
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
Search for more papers by this authorAjeet Singh
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
Search for more papers by this authorFaryal Rafique
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
Search for more papers by this authorAbu Baker Sheikh
Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Search for more papers by this authorCorresponding 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 authorCorresponding 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 authorSurabhi Maheshwari
Department of Internal Medicine, University of Alabama at Montgomery, Montgomery, Alabama, USA
Search for more papers by this authorYusra Mashkoor
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
Search for more papers by this authorAjeet Singh
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
Search for more papers by this authorFaryal Rafique
Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
Search for more papers by this authorAbu Baker Sheikh
Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
Search for more papers by this authorCorresponding 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 authorABSTRACT
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.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
Filename | Description |
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ccd31607-sup-0001-CCI_R1_Supplementary_File_TAVR.docx415.1 KB | CCI R1 Supporting File TAVR. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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