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• W4376277589 abstract "Aortic stenosis (AS) and cardiac amyloidosis (CA) occur concomitantly in a significant number of patients and portend a higher risk of all-cause mortality. Previous studies have investigated outcomes in patients with concomitant CA/AS who underwent transcatheter aortic valve implantation (TAVI) versus medical therapy alone, but no evidence-based consensus regarding the ideal management of these patients has been established. Medline, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Methodologic bias was assessed using the modified Newcastle-Ottawa scale for observational studies. A total of 4 observational studies comprising 83 patients were included. Of these, 45 patients (54%) underwent TAVI, whereas 38 (46%) were managed conservatively. Of the 3 studies that included baseline characteristics by treatment group, 30% were women. The risk of all-cause mortality was found to be significantly lower in patients who underwent TAVI than those treated with conservative medical therapy alone (odds ratio 0.24, 95% confidence interval 0.08 to 0.73). In conclusion, this meta-analysis suggests a lower risk of all-cause mortality in patients with CA with AS who underwent TAVI than those managed with medical therapy alone. Aortic stenosis (AS) and cardiac amyloidosis (CA) occur concomitantly in a significant number of patients and portend a higher risk of all-cause mortality. Previous studies have investigated outcomes in patients with concomitant CA/AS who underwent transcatheter aortic valve implantation (TAVI) versus medical therapy alone, but no evidence-based consensus regarding the ideal management of these patients has been established. Medline, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Methodologic bias was assessed using the modified Newcastle-Ottawa scale for observational studies. A total of 4 observational studies comprising 83 patients were included. Of these, 45 patients (54%) underwent TAVI, whereas 38 (46%) were managed conservatively. Of the 3 studies that included baseline characteristics by treatment group, 30% were women. The risk of all-cause mortality was found to be significantly lower in patients who underwent TAVI than those treated with conservative medical therapy alone (odds ratio 0.24, 95% confidence interval 0.08 to 0.73). In conclusion, this meta-analysis suggests a lower risk of all-cause mortality in patients with CA with AS who underwent TAVI than those managed with medical therapy alone. Cardiac Amyloidosis in Patients With Severe Aortic Stenosis: Not a Good Reason to Say No to Transcatheter Aortic Valve ImplantationAmerican Journal of CardiologyVol. 200PreviewThe association between cardiac amyloidosis (CA) and aortic stenosis (AS) is quite common among older patients because the prevalence of both conditions increases with age. In fact, it is estimated that 1 in 10 patients with high-gradient severe AS and 1 in 3 patients with low-flow low-gradient AS may have CA.1 CA is characterized by an infiltrative process with deposition of amyloid fibrils in the myocardium, which can comprise transthyretin (more often in older adults) or immunoglobulin light-chain in patients with myeloma. Full-Text PDF" @default.
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• W4376277589 date "2023-07-01" @default.
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• W4376277589 title "Transcatheter Aortic Valve Implantation in Cardiac Amyloidosis and Aortic Stenosis" @default.
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• W4376277589 doi "https://doi.org/10.1016/j.amjcard.2023.04.003" @default.
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