Key result
Active cancer in TAVR patients is linked to ~93% higher 1-year mortality despite similar in-hospital survival.
Why the study?
The clinical outcomes and prognostic implications of TAVR in patients with active cancer remain uncertain.
Does active cancer affect mortality and complication rates in patients undergoing TAVR for severe aortic stenosis?
Meta-Analysis (n=200,265)
Yes
Does active cancer affect mortality and complication rates in patients undergoing TAVR for severe aortic stenosis?
Odds Ratio: 1.17 (95% CI 0.83–1.65)
p-value: p=0.27
TAVR provides comparable short-term survival and procedural safety in patients with active cancer compared to those without, though long-term mortality is significantly higher.
Supports short-term TAVR safety in active cancer; leaves open long-term outcome optimization in observational data.
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for high-risk patients with severe aortic stenosis (AS). However, the clinical outcomes and prognostic implications of TAVR in patients with active cancer remain uncertain. This meta-analysis evaluates procedural success, complications, and survival outcomes of TAVR in patients with and without active cancer. METHODS: A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases. Statistical analysis was performed using a random-effects model. Statistical analyses were conducted using STATA version 18.0. RESULTS: The results of the meta-analysis showed no significant difference in in-hospital mortality between cancer and non-cancer patients (OR = 1.17; 95% CI: 0.83, 1.65; p = 0.27). Similarly, 30-day mortality did not differ between the two groups (OR = 0.93; 95% CI: 0.72, 1.19; p = 0.49). However, 1-year mortality was significantly higher in cancer patients (OR = 1.93; 95% CI: 1.45, 2.56; p < 0.01). Two-year mortality was also higher in cancer patients (OR = 2.65; 95% CI: 1.79, 3.93; p < 0.01). No significant differences were observed in major bleeding, acute kidney injury, stroke, or permanent pacemaker implantation between the groups. CONCLUSION: While TAVR offers comparable in-hospital and short-term survival outcomes for cancer and non-cancer patients, long-term mortality is significantly higher in those with active cancer. These findings suggest that TAVR is a viable option for cancer patients with severe AS but requires careful long-term prognostic considerations. Further studies are needed to optimize management strategies for this complex population.
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Saberian et al. (2025) conducted a meta-analysis in Severe aortic stenosis (n=200,265). Active cancer vs. No active cancer was evaluated on In-hospital mortality (OR 1.17, 95% CI 0.83, 1.65, p=0.27). In patients undergoing transcatheter aortic valve replacement, active cancer was associated with significantly higher 1-year mortality (OR 1.93) but no significant difference in in-hospital mortality (OR 1.17) compared to patients without cancer.
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