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Gut microbiota induces high platelet response in patients with ST segment elevation myocardial infarction after ticagrelor treatment Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the Efficacy of Xience/Promus Versus Cypher to Reduce Late Loss After Stenting (EXCELLENT) randomized, multicenter study Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy: the SECURITY randomized clinical trial Ticagrelor versus clopidogrel in patients with acute coronary syndromes Dual antiplatelet therapy (PEGASUS) vs. dual pathway (COMPASS): a head-to-head in vitro comparison Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial Adjunctive Cilostazol to Dual Antiplatelet Therapy to Enhance Mobilization of Endothelial Progenitor Cell in Patients with Acute Myocardial Infarction: A Randomized, Placebo-Controlled EPISODE Trial Ticagrelor versus clopidogrel in elective percutaneous coronary intervention (ALPHEUS): a randomised, open-label, phase 3b trial ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting
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Review Article2019 May 25. pii: S0002-9149(19)30584-3.

JOURNAL：Am J Cardiol. Article Link

Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort

Ando T, Ashraf S, Villablanca P et al. Keywords: transcatheter aortic valve implantation; surgical aortic valve replacement; low-to-intermediate surgical risk cohort

ABSTRACT

Transcatheter aortic valve implantation (TAVI) has been used to treat high surgical risk cohorts but has been expanded to treat low-to-intermediate risk cohort as well. We performed a systematic review and meta-analysis to compare the outcomes between TAVI and surgical aortic valve replacement (SAVR) in low-to-intermediate risk cohort. We queried PUBMED, EMBASE, and ClinicalTrial.gov for relevant articles. Randomized controlled trials that compared at least one of the outcomes of interest between TAVI and SAVR were included. Risk ratio (RR) and 95% confidence interval (CI) were pooled with a random-effects model to compare the risk of the primary outcome between the 2 procedures. The primary outcome was a composite of all-cause mortality or disabling/major stroke at 1 year. Seven studies with a total of 7,143 patients (3,665 TAVI) were included. All-cause mortality or disabling/major stroke at 30 days (6 studies, RR 0.71, 95% CI 0.49 to 1.03) was similar between TAVI and SAVR but was significantly lower in TAVI at 1 year (5 studies, RR 0.81, 95% CI 0.67 to 0.98). All-cause mortality was similar at both 30 days (7 studies, RR 0.90, 95% CI 0.67 to 1.21) and 1 year (6 studies, RR 0.89, 95% CI 0.76 to 1.04). Disabling/major stroke was similar between the 2 procedures (6 studies, RR 0.69, 95% CI 0.42 to 1.12) at 30 days but was significantly lower in TAVI at 1 year (5 studies RR 0.71, 95% CI 0.51 to 0.98). Age, gender, diabetes, and surgical risk score did not modulate the primary outcome. TAVI had a significantly lower composite of all-cause mortality or disabling/major stroke at 1 year compared with SAVR in low-to-intermediate surgical risk cohort.

Copyright © 2019 Elsevier Inc. All rights reserved.

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