Key result
Transcatheter aortic valve replacement significantly reduced acute kidney injury at 30 days compared to surgical aortic valve replacement (OR 0.38) in patients with severe aortic stenosis.
Why the study?
Acute kidney injury following aortic valve replacement is associated with poor prognosis, prompting a comparison of renal outcomes between TAVR and SAVR.
Does transcatheter aortic valve replacement reduce acute kidney injury compared to surgical aortic valve replacement in patients with severe aortic stenosis?
Meta-Analysis (n=7,889)
Does transcatheter aortic valve replacement reduce acute kidney injury compared to surgical aortic valve replacement in patients with severe aortic stenosis?
Effect estimate: OR 0.38 (95% CI 0.28-0.51)
Absolute Event Rate: 66% vs 160%
p-value: p=<0.00001
TAVR is associated with a significantly lower risk of acute kidney injury at 30 days compared to SAVR across patients with severe aortic stenosis.
Supports TAVR selection for renal protection in severe AS; confirms lower AKI risk versus SAVR across aggregated trials.
Background Acute kidney injury (AKI) following aortic valve replacement is associated with poor prognosis. Transcatheter aortic valve replacement (TAVR) is a novel strategy with a percutaneous approach and early recovery time. We conducted this meta-analysis to compare TAVR to surgical aortic valve replacement (SAVR) and their respective renal outcomes. Methods We searched for randomized controlled trials (RCTs) using MEDLINE, PUBMED, and Google Scholar databases from their inception till April 6, 2019, and included eight trials comparing TAVR to SAVR in cases that reported AKIs. Results We found a significant reduction in AKI after TAVR compared to SAVR at 30 days [n = 66 vs. n = 160, respectively; odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.28-0.51; p: <0.00001, I2 = 0%]. At one year, a trend towards reduced renal failure was noted in the TAVR arm compared to the SAVR arm (n = 74 vs. n = 129, respectively; OR = 0.57, 95% CI = 0.32-1.01; p = 0.05, I2 = 69%). Conclusion Based on our findings and analysis, we have concluded that TAVR is associated with significantly reduced renal injury at 30 days when compared to SAVR.
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Siddiqui et al. (2020) conducted a meta-analysis in Severe aortic stenosis (n=7,889). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on Acute kidney injury at 30 days (OR 0.38, 95% CI 0.28-0.51, p=<0.00001). Transcatheter aortic valve replacement significantly reduced acute kidney injury at 30 days compared to surgical aortic valve replacement (OR 0.38) in patients with severe aortic stenosis.
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