The Effect of Periprocedural Statin Therapy on Mortality and Cardiovascular Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis
Abstract Body (Do not enter title and authors here):
Background Transcatheter aortic valve replacement (TAVR) stands as a notable alternative to surgery 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. Our study aims to assess whether perioperative statin use improves survival and outcomes post-TAVR.
Methods A search was conducted across various databases to retrieve studies comparing perioperative statin use versus no statin use in patients undergoing TAVR. The primary outcome of interest was all-cause mortality (ACM). Secondary outcomes included stroke, acute kidney injury (AKI), 30-day mortality, myocardial infarction (MI), cardiovascular complications, and in-hospital mortality. Comprehensive Meta-Analysis Software (v. 3) was used to pool odds ratio (OR) under a random-effects model, with statistical significance set at p < 0.05. Results Our analysis encompassing 20663 patients from 15 observational studies found that perioperative statin use was associated with a significant reduction in ACM (OR= 0.71, 95% CI: 0.61-0.83, I2= 50.3%, p<0.001). Although not statistically significant, perioperative statin use demonstrated a trend towards a decreased risk of stroke (OR= 0.90, 95% CI: 0.68-1.19, I2= 0%, p= 0.455), AKI (OR= 0.99, 95% CI: 0.75-1.31, I2= 49%, p= 0.968), and 30-day mortality (OR= 0.71, 95% CI: 0.46-1.10, I2= 0%, p= 0.126), and no difference was seen in the risk of MI (OR= 1.72, 95% CI: 0.73-4.04, I2= 0%, p= 0.214), cardiovascular complications (OR= 1.12, 95% CI: 0.91-1.37, I2= 0%, p= 0.297), and in-hospital mortality (OR= 0.42, 95% CI: 0.13-1.38, I2= 65.8%, p= 0.151) (Figure 1 and 2).
Conclusion Perioperative statin therapy reduces all-cause mortality in TAVR patients but shows limited impact on other outcomes. Further large-scale prospective studies and trials are necessary to corroborate our findings.
Goyal, Aman
( Seth GS Medical College and KEM Hospital
, Panchkula
, India
)
Belur, Agastya
( University of Louisville
, Louisville
, Kentucky
, United States
)
Mashkoor, Yusra
( Dow University of Health Sciences
, Karachi
, Pakistan
)
Abbasi, Haleema Qayyum
( Ayub Medical College
, Abbottabad
, Pakistan
)
Khan, Rozi
( Medical University of South Carolina
, Florence
, South Carolina
, United States
)
Jain, Hritvik
( All India Institute of Medical Sciences-Jodhpur
, Jodhpur
, India
)
Rathore, Sawai Singh
( Dr. Sampurnanand Medical College
, Jodhpur
, India
)
Puttaswamy, Darshan
( Seth GS Medical College and KEM Hospital
, Panchkula
, India
)
Moeed, Abdul
( Dow Medical College
, Karachi, Sindh
, Pakistan
)
Sulaiman, Samia
( University of Jordan
, Amman
, Jordan
)
Author Disclosures:
Aman Goyal:DO NOT have relevant financial relationships
| Agastya Belur:No Answer
| Yusra Mashkoor:DO NOT have relevant financial relationships
| Haleema Qayyum Abbasi:DO NOT have relevant financial relationships
| Rozi Khan:DO NOT have relevant financial relationships
| Hritvik Jain:DO NOT have relevant financial relationships
| Sawai Singh Rathore:DO NOT have relevant financial relationships
| Darshan Puttaswamy:DO NOT have relevant financial relationships
| Abdul Moeed:DO NOT have relevant financial relationships
| Samia Sulaiman:DO NOT have relevant financial relationships
Oliveira Izadora, Graner Moreira Humberto, De Sousa Andre, Paiva Arthur, Ferreira Vitor, De Sá Carlos Eduardo, Alves Alencar Joao Victor, Alves Alencar Pedro Lucas, Duarte Lima Ana Paula, Oliveira Vinicius