Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/23467
Title: Transcatheter aortic valve replacement in patients with a history of cancer: Periprocedural and long-term outcomes.
Authors: Murphy, Alexandra C;Koshy, Anoop N;Cameron, William;Horrigan, Mark;Kearney, Leighton;Yeo, Belinda;Farouque, Omar;Yudi, Matias B
Affiliation: Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
Department of Oncology, The Olivia Newton-John Cancer and Wellness Centre, Melbourne, Victoria, Australia
Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
Issue Date: 4-Jun-2020
EDate: 2020-06-04
Citation: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2020; online first: 4 June
Abstract: A history of cancer is incorporated into the surgical risk assessment of patients undergoing surgical aortic valve replacement through the Society for Thoracic Surgeons score. However, the prognostic significance of cancer in patients treated with transcatheter aortic valve replacement (TAVR) is unclear. As the cancer survivorship population increases, it is imperative to establish the efficacy and safety of TAVR in patients with severe symptomatic aortic stenosis (AS) and a history of malignancy. The primary goal of this study was to assess the periprocedural outcomes and long-term mortality in patients with a history of cancer undergoing TAVR. A systematic review of PubMed, MEDLINE, and EMBASE was conducted to identify studies reporting outcomes in patients with a history of malignancy undergoing TAVR. A meta-analysis was performed using a random-effects model with a primary outcome of all-cause mortality and cardiac mortality at the longest follow-up. On secondary analyses, procedural safety was assessed. A total of 13 observational studies with 10,916 patients were identified in the systematic review. Seven studies including 6,323 patients were included in the quantitative analysis. Short-term mortality (relative risk [RR] 0.61, 95%CI 0.36-1.01; p = .06) and long-term all-cause mortality (RR 1.24, 95%CI 0.95-1.63; p = .11) were not significantly different when comparing patients with and without a history of cancer. No significant difference in the rate of periprocedural complications including stroke, bleeding, acute kidney injury, and pacemaker implantation was noted. In patients with severe AS undergoing TAVR, a history of cancer was not associated with adverse short or long-term survival. Based on these findings, TAVR should be considered in all patients with severe symptomatic AS, irrespective of their history of malignancy.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23467
DOI: 10.1002/ccd.28969
ORCID: 0000-0002-4248-7537
0000-0002-8741-8631
0000-0002-3706-4150
0000-0002-9218-9917
PubMed URL: 32497385
Type: Journal Article
Subjects: aortic valve disease
comparative effectiveness/patient-centered outcomes research
percutaneous intervention
transcatheter valve implantation
Appears in Collections:Journal articles

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