000			03812nam a22004217a 4500
008			150313s20142014 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
040			_aOvid MEDLINE(R)
099			_a25217456
245			_aMeta-analysis of predictors of all-cause mortality after transcatheter aortic valve implantation. [Review]
251			_aAmerican Journal of Cardiology. 114(9):1447-55, 2014 Nov 1.
252			_aAm J Cardiol. 114(9):1447-55, 2014 Nov 1.
253			_aThe American journal of cardiology
260			_c2014
260			_fFY2015
266			_d2015-03-17
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aThe aim of this study was to identify predictors of 30-day and midterm mortality after transcatheter aortic valve implantation (TAVI) by means of a systemic review. TAVI was demonstrated to be safe and efficacious in patients with severe aortic stenosis. An accurate estimation of procedural risk of these patients represents an actual challenge. The PubMed and Cochrane Collaboration databases were systematically searched for studies reporting on the incidence and independent predictors of 30-day and midterm mortality. Adverse events were pooled with random effect, whereas independent predictors are reported as odds ratios (ORs) with 95% confidence intervals (CIs). A total of 25 studies with 8, 874 patients were included (median age 82.5 +/- 1.5 years, 54.6% women). At 30 days, 7.5% of patients (n = 663) died. At midterm follow-up (median 365 days, interquartile range 267 to 365 days), the cumulative mortality rate was 21.6% (n = 1, 917). Acute kidney injury (AKI) stage >2 (OR 18.0, 95% CI 6.3 to 52), preprocedural hospitalization for heart failure (OR 9.4, 95% CI 2.6 to 35), periprocedural acute myocardial infarction (OR 8.5, 95% CI 2.6 to 33.5), and increased pro-brain natriuretic peptide (pro-BNP) levels (OR 5.4, 95% CI 1.7 to 16.5) were the most important independent predictors of 30-day mortality. Increased pro-BNP levels (OR 11, 95% CI 1.5 to 81), AKI stage 3 (OR 6.8, 95% CI 2.6 to 15.7), left ventricular ejection fraction <30% (OR 6.7, 95% CI 3.5 to 12.7), and periprocedural acute myocardial infarction (OR 6.5, 95% CI 2.3 to 18.1) represented the predictors of midterm mortality. In conclusion, in this large meta-analysis of patients undergoing TAVI, we found that high pro-BNP levels and postprocedural AKI were the strongest independent predictors of both 30-day and 1-year mortality. These findings may contribute to a better understanding of the risk assessment process of patients undergoing TAVI. Copyright � 2014 Elsevier Inc. All rights reserved.
546			_aEnglish
650			_a*Aortic Valve Stenosis/su [Surgery]
650			_a*Postoperative Complications/mo [Mortality]
650			_a*Risk Assessment
650			_a*Transcatheter Aortic Valve Replacement/mo [Mortality]
650			_aAortic Valve Stenosis/mo [Mortality]
650			_aCause of Death
650			_aGlobal Health
650			_aHumans
650			_aRisk Factors
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
657			_aMeta-Analysis
657			_aReview
700			_aBarbash, Israel M
700			_aWaksman, Ron
790			_aAmabile N, Baan J, Barbash IM, Biondi Zoccai G, Chieffo A, Codner P, Colombo A, Conrotto F, D'Amico M, D'Ascenzo F, D'Onofrio A, Dumonteil N, Gaita F, Giordana F, Kornowski R, La Torre M, Latib A, Lefevre T, Marra S, Moretti C, Nickenig G, Nijhoff F, Omede P, Pilgrim T, Rinaldi M, Salizzoni S, Sinning JM, Tchetche D, Van Mieghem NM, Waksman R, Yong ZY
856			_uhttp://dx.doi.org/10.1016/j.amjcard.2014.07.081 _zhttp://dx.doi.org/10.1016/j.amjcard.2014.07.081
942			_cART _dArticle
999			_c1077 _d1077