Impact of obesity on outcomes of transcatheter aortic valve implantation in patients with aortic stenosis: a systematic review and meta-analysis of real-world data

Q: What are the key findings of this study?

Obesity (BMI ≥30 kg/m2) significantly reduced 30-day all-cause mortality (OR 0.71) and improved long-term overall survival (HR 0.87) compared to normal weight in patients undergoing TAVI.

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Aortic stenosis (n=38743). Intervention: Obesity (BMI ≥30 kg/m2) vs. Normal weight (BMI 18.5 to <25 kg/m2). Primary outcome: 30-day all-cause mortality (OR 0.71, 95% CI 0.60-0.84, p=<0.0001).

Q: What does this research mean for the field?

Obesity (BMI ≥30 kg/m2) significantly reduces 30-day all-cause mortality and improves long-term overall survival compared to normal weight in patients undergoing transcatheter aortic valve implantation (TAVI), without increasing procedural complications. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the impact of obesity and body mass index on procedural complications and long-term survival in patients with aortic stenosis undergoing transcatheter aortic valve implantation.

Farah Yasmin

doi:10.62347/vtye4110

January 1, 2025American Journal of Cardiovascular DiseaseOpen Access

Impact of obesity on outcomes of transcatheter aortic valve implantation in patients with aortic stenosis: a systematic review and meta-analysis of real-world data

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Key result

Obesity is linked to ~29% lower 30-day mortality vs normal weight in TAVI patients.

OR 0.71
95% CI 0.60-0.84
P<0.0001
n=38,743

Why the study?

Does obesity improve overall survival in patients with aortic stenosis undergoing transcatheter aortic valve implantation?

Key Points

To evaluate the impact of obesity and body mass index on procedural complications and long-term survival in patients with aortic stenosis undergoing transcatheter aortic valve implantation.
Conducted a systematic review and meta-analysis synthesizing real-world observational data of patients undergoing transcatheter aortic valve implantation for aortic stenosis.
Evaluated clinical endpoints including overall survival, myocardial infarction, major bleeding, major vascular events, and acute kidney injury across body mass index categories.
Increased body mass index was significantly associated with improved overall survival (HR 0.96, P < 0.0001), with obese patients achieving superior long-term overall survival compared to non-obese individuals (HR 0.87, P < 0.00001).
No significant differences occurred between obese and non-obese cohorts for myocardial infarction (OR 0.84, 95% CI 0.52–1.34), major bleeding (OR 0.94, 95% CI 0.72–1.21), major vascular events (OR 1.18, 95% CI 0.97–1.43), or acute kidney injury (OR 1.17, 95% CI 0.87–1.56).

Study Design

Type

Meta-Analysis (n=38,743)

Multicenter

Yes

Structured PICO

Does obesity improve overall survival in patients with aortic stenosis undergoing transcatheter aortic valve implantation?

P

Population

Patients with aortic stenosis undergoing transcatheter aortic valve implantation

I

Intervention

Obesity (increased BMI)

C

Comparator

Non-obese patients

O

Outcome

Overall survivalhard clinical

Main Result

Effect estimate: OR 0.71 (95% CI 0.60-0.84)

p-value: p=<0.0001

In patients undergoing TAVI for aortic stenosis, obesity is associated with improved long-term overall survival without an increase in procedural complications, demonstrating an obesity paradox.

Limitations

Most included studies were retrospective, leading to potential recall bias
Inability to conduct subgroup analysis for TAVI access sites, race differences, and AS severity
Some studies utilized univariate odds ratios
Lack of adjustment for comorbidities like hypertension, diabetes, and coronary heart disease

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Implication

Obesity may confer TAVI survival benefit; extends meta-analytic support for the obesity paradox without altering practice.

Abstract

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Discussion

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Cite This Study

Farah Yasmin (2025) conducted a meta-analysis in Aortic stenosis (n=38,743). Obesity (BMI ≥30 kg/m2) vs. Normal weight (BMI 18.5 to <25 kg/m2) was evaluated on 30-day all-cause mortality (OR 0.71, 95% CI 0.60-0.84, p=<0.0001). Obesity (BMI ≥30 kg/m2) significantly reduced 30-day all-cause mortality (OR 0.71) and improved long-term overall survival (HR 0.87) compared to normal weight in patients undergoing TAVI.

synapsesocial.com/papers/6a11ccb61d1aaf8555562f08 https://doi.org/10.62347/vtye4110

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Impact of obesity on outcomes of transcatheter aortic valve implantation in patients with aortic stenosis: a systematic review and meta-analysis of real-world data

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Impact of obesity on outcomes of transcatheter aortic valve implantation in patients with aortic stenosis: a systematic review and meta-analysis of real-world data

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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