在中期风险患者中中风的频率在长期接受TAVR与SAVR:系统性审查和元分析
Jordan Llerena-Velastegui1, Carolina Navarrete-Cadena1, Fabian Delgado-Quijano2
1Pontifical Catholic University of Ecuador, Medical School, Quito, Ecuador.
Current problems in cardiology
|September 23, 2023
概括
透气管大动脉置换 (TAVR) 和手术大动脉置换 (SAVR) 在中等风险患者中显示出类似的长期中风风险. 两种手术都没有在预防手术后中风发病率方面提供显著的优势.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 大动脉狭窄的管理涉及复杂的关于门更换的决策.
- 过导管大动脉置换 (TAVR) 和手术大动脉置换 (SAVR) 是主要的治疗选择.
- 了解长期中风风险对于患者的选择和结果至关重要.
研究的目的:
- 为了比较中风后的中风的长期发病率,TAVR与SAVR在中等风险患者中.
- 为了确定TAVR是否与SAVR相比提供了降低中风风险.
- 在大动脉狭窄治疗中为临床决策提供信息.
主要方法:
- 对相关研究进行系统审查和元分析.
- 从Embase,Cochrane图书馆和PubMed数据库中检索数据.
- 对森林地块进行分析,以合成中风发病率数据.
主要成果:
- 在TAVR和SAVR组之间没有观察到中风发病率的显著差异 (P=0.76,95% CI:0.80-1.17).
- 聚合的元分析数据没有表明TAVR的中风频率降低.
- 对于中等风险患者来说,这两种手术的中风风险都相当.
结论:
- 在中等风险人群中,TAVR和SAVR与类似的长期中风风险有关.
- 目前的证据表明,无论是TAVR还是SAVR,在中风方面都不是本质上更安全的.
- 考虑个体患者因素的共同决策对于管理大动脉狭窄症至关重要.
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