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Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients

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dc.contributor.author Diaz-Arocutipa, Carlos
dc.contributor.author Torres-Valencia, Javier
dc.contributor.author Zavaleta-Camacho, Gabriela
dc.contributor.author Vicent, Lourdes
dc.date.accessioned 2021-12-12T20:24:59Z
dc.date.available 2021-12-12T20:24:59Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/10295
dc.description.abstract Background: It has been proposed that transcatheter aortic valve replacement (TAVR) may be an option for patients with cancer and severe aortic stenosis. We assessed the association between previous or active cancer and clinical outcomes in TAVR patients. Methods: We searched four electronic databases from inception to March 05, 2021. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, myocardial infarction, stroke, acute kidney injury, pacemaker implantation, major bleeding, and vascular complications. All meta-analyses were performed using a random-effects model. Relative risks (RRs) and adjusted hazard ratios (aHRs) with their 95% confidence interval (95% CI) were pooled. Results: Thirteen cohort studies involving 255,840 patients were included. The time period for mortality ranged from inpatient to 10 years. Patients with active cancer had a higher risk of all-cause mortality using both crude (RR, 1.46; 95% CI, 1.13-1.88) and adjusted (aHR, 1.79; 95% CI, 1.43-2.25) estimates compared to non-cancer group. In contrast, the risk of cardiovascular mortality (RR, 1.26; 95% CI, 0.58-2.73), myocardial infarction (RR, 0.94; 95% CI, 0.34-2.57), stroke (RR, 0.90; 95% CI, 0.75-1.09), pacemaker implantation (RR, 0.87; 95% CI, 0.50-1.53), acute kidney injury (RR, 0.88; 95% CI, 0.74-1.04), major bleeding (RR, 1.15; 95% CI, 0.80-1.66), and vascular complications (RR, 0.96; 95% CI, 0.79-1.18) was similar between patients with or without cancer. Conclusion: Our review shows that TAVR patients with active cancer had an increased risk of all-cause mortality. No significant association with secondary outcomes was found en_US
dc.language.iso eng
dc.publisher Frontiers Media
dc.relation.ispartofseries Frontiers in Cardiovascular Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject mortality en_US
dc.subject systematic review en_US
dc.subject aortic stenosis en_US
dc.subject cancer en_US
dc.subject TAVR en_US
dc.title Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.3389/fcvm.2021.763557
dc.relation.issn 2297-055X


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