Clinical impact of baseline chronic kidney disease in patients undergoing transcatheter or surgical aortic valve replacement
Key result
Among high-risk patients with moderate/severe chronic kidney disease, TAVR resulted in a lower 3-year rate of major adverse cardiovascular and renal events compared with SAVR (42.1% vs. 51.0%, P=0.04).
Why the study?
Does TAVR reduce MACRE compared to SAVR in high-risk patients with moderate/severe CKD?
Population
High-risk patients undergoing transcatheter or surgical aortic valve replacement, retrospectively stratified…
Comparison
Transcatheter aortic valve replacement (TAVR) vs Surgical aortic valve replacement (SAVR)
Design
Cohort, Patients were originally randomized to TAVR or SAVR in the CoreValve…
Follow-up
3 years
Authors
Discussion
Loading...
Member takes
Implication
TAVR was associated with lower MACRE in high-risk moderate/severe CKD; leaves open whether RCTs will confirm benefit versus SAVR.
Study Design
Type
RCT (n=3,733)
Randomization
randomized
Structured PICO
Does TAVR reduce MACRE compared to SAVR in high-risk patients with moderate/severe CKD?
P
Population
High-risk patients randomized to TAVR or SAVR, and 3,733 extreme- and high-risk patients undergoing TAVR, stratified by baseline chronic kidney disease and followed for 3 years.
I
Intervention
Transcatheter aortic valve replacement (TAVR)
C
Comparator
Surgical aortic valve replacement (SAVR)
O
Outcome
Major adverse cardiovascular and renal events (MACRE), a composite of all-cause mortality, myocardial infarction, stroke/TIA, and new requirement of dialysis at 3 yearscomposite
Main Result
Absolute Event Rate: 42.1% vs 51%
p-value: p=.04
TAVR is associated with lower 3-year MACRE compared to SAVR in high-risk patients with moderate to severe chronic kidney disease.
Cite This Study
Pineda et al. (2018) conducted an RCT in Aortic valve disease with chronic kidney disease (n=3,733). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on major adverse cardiovascular and renal events (MACRE), a composite of all-cause mortality, myocardial infarction, stroke/TIA, and new requirement of dialysis (p=.04). Among high-risk patients with moderate/severe chronic kidney disease, TAVR resulted in a lower 3-year rate of major adverse cardiovascular and renal events compared with SAVR (42.1% vs. 51.0%, P=0.04).