Indian heart journal最新文献

{"title":"Upfront Aspirin-Free Antiplatelet Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Safety and Efficacy.","authors":"Kunal Mahajan, Deep Dutta, A B M Kamrul-Hasan, Akshyaya Pradhan, Shekhar Vohra, Nitin Mahajan","doi":"10.1016/j.ihj.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.ihj.2026.04.002","url":null,"abstract":"<p><strong>Background: </strong>Evidence comparing non-aspirin single antiplatelet therapy (SAPT) with aspirin-containing dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is limited. We performed a systematic review and meta-analysis to evaluate the safety and efficacy of non-aspirin SAPT with a P2Y12​ inhibitor started at or within one week of PCI.</p><p><strong>Methods: </strong>Electronic databases were searched for studies evaluating non-aspirin SAPT after PCI. Primary outcomes were bleeding defined by Bleeding Academic Research Consortium (BARC) criteria [BARC 1-5 (any bleeding) and BARC 3-5 (major bleeding)], all-cause mortality (ACM), and cardiovascular mortality. Secondary outcomes were stroke, myocardial infarction (MI), need for revascularization, and stent thrombosis (STS).</p><p><strong>Results: </strong>Seven studies (2 randomized controlled trials and 5 observational studies) including 5468 patients on non-aspirin SAPT were analysed. In the single-arm meta-analysis of non-aspirin SAPT, pooled prevalence was 5% (95% CI 3-11;I²=92%) for any BARC 1-5 bleeding, 3% (95% CI 1-7;I²=92.5%) for major BARC 3-5 bleeding, 2% (95% CI 1-3;I²=65.4%) for ACM, 2% (95% CI 2-3;I²=31%) for cardiovascular mortality, 1% (95% CI 1-1;I²=0%) for STS, 1% (95% CI 0-1;I²=40.1%) for stroke, 2% (95% CI 1-3;I²=66.6%) for MI, and 2% (95% CI 1-4;I²=75.9%) for revascularization. In pairwise analyses of the two trials, non-aspirin SAPT versus aspirin-based DAPT showed similar risks of all-cause mortality, cardiovascular mortality, bleeding, and stroke but higher risks of MI (odds ratio [OR]1.41;95% CI 1.01-1.97; P=0.05; I²=0%) and revascularization (OR1.73; 95% CI 1.18-2.52;P=0.005;I²=0%).</p><p><strong>Conclusion: </strong>Upfront aspirin-free SAPT after PCI was associated with increased risks of MI and revascularization without a reduction in bleeding compared with aspirin-based DAPT.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting non-HACEK gram-negative endocarditis: Emerging clinical and microbiological trends from a prospective cohort.","authors":"Durga Shankar Meena, Deepak Kumar, Bhuvanesh Kumar, Gopal Krishana Bohra, Naresh Midha, Rahul Choudhary, Surender Deora, Vibhor Tak, Alok Kumar Sharma, Mahesh Devnani","doi":"10.1016/j.ihj.2026.03.007","DOIUrl":"10.1016/j.ihj.2026.03.007","url":null,"abstract":"<p><strong>Background: </strong>Non-HACEK gram-negative pathogens are an emerging cause of infective endocarditis (IE) with limited data from lower-middle-income countries. This study aimed to evaluate the clinical characteristics, treatment, and outcomes of non-HACEK gram-negative IE in an Indian cohort.</p><p><strong>Methods: </strong>This prospective observational study was conducted in a tertiary care center in western India. Clinical presentation, microbiology, echocardiographic findings, and treatment outcomes of non-HACEK gram-negative IE were analyzed and compared with patients who had IE due to other etiology.</p><p><strong>Results: </strong>Among 121 patients with IE, 30 cases (24.8%) were due to non-HACEK gram-negative pathogens (median age: 48 years; 73.3% male). In this group, predisposing cardiac conditions were present in 56%, including prosthetic valves/devices in 26.6%. Pseudomonas aeruginosa was the most common etiology (n = 14, 46.6%), followed by E. coli (n = 6, 20%). The median vegetation size was 12 mm. Common complications included heart failure (56.7%), peripheral septic emboli (40%), and stroke (33.3%). Surgical intervention was performed in 23.3% of cases. The 60-day and 1-year mortality rates were 36% and 43.3%, respectively; relapse occurred in 11.8% of 1-year survivors. Compared to other etiology (n = 91), non-HACEK gram-negative IE had a significantly higher Charlson Comorbidity Index (2 vs 1, p = 0.035), persistent bacteremia (30% vs 12%, p = 0.02), and 60-day mortality (36.6% vs 17.6%, p = 0.032).</p><p><strong>Conclusions: </strong>Non-HACEK gram-negative IE predominantly caused by Pseudomonas aeruginosa, is increasingly recognized. Compared to other etiology, Non-HACEK gram-negative IE was linked to higher comorbidity scores, frequent persistent bacteremia, and greater early mortality, highlighting its aggressive clinical course.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, efficacy, and outcomes of the modified rotational atherectomy approach: A real-world single-center experience.","authors":"Ravinder Singh Rao, Kailash Chandra, Govind Narayan Sharma, Prashant Sk Varshney, Piyush Joshi, Somyata Somendra, Sanjeev Kumar, Nagendra Boopathy Senguttuvan","doi":"10.1016/j.ihj.2026.03.005","DOIUrl":"10.1016/j.ihj.2026.03.005","url":null,"abstract":"<p><strong>Background: </strong>Rotational atherectomy (RA) is advantageous in calcified coronary lesions to ablate calcified plaques and optimize stent expansion but associated with complications like coronary perforation, dissection, and slow/no-reflow.</p><p><strong>Aim: </strong>To evaluate the safety and periprocedural outcomes of RA with a modified approach in a real-world Indian scenario.</p><p><strong>Methods: </strong>This 6-year, retrospective, single-operator study at an Indian tertiary care institution included 320 patients, operated using a modified RA approach, which integrated slow burr speed (150,000-155,000 revolutions per minute), short runs and pretreatment adrenaline with aminophylline to avoid temporary pacemaker (TPM). Data on demographics, periprocedural characteristics, and complications were collected. The primary endpoint was angiographic and procedural success.</p><p><strong>Results: </strong>The patient cohort comprised predominantly men (80.31%) with a mean age of 67.92 ± 9.16 years. Common comorbidities included acute coronary syndrome (67.81%), diabetes mellitus (50.93%), and hypertension (67.81%). A total of 322 RA procedures (414 lesions) were performed. Of these 414 lesions, 7% were chronic total occlusions while 8.9% were in the left main coronary artery. TPM insertion was done in one (0.31%) patient who already had complete heart block. Imaging was performed in 35% of the procedures. Procedural success was achieved in 96.90% of the cases. Complications included slow flow/no-reflow in 4 cases (1.24%), dissection in 4 cases (1.24%), and burr entrapment in 2 cases (0.62%).</p><p><strong>Conclusion: </strong>The use of TPM can be avoided during RA, and slow/no reflow incidence can be reduced with pretreatment aminophylline and adrenaline. Small burr sizes with a slow rotation speed and short runs are key for safe and effective calcium ablation with this debulking modality.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral embolic protection devices in transcatheter aortic valve implantation: An updated meta-analysis of randomized controlled trials","authors":"Ensieh Sadat Mansouri ,&nbsp;Flavia Queiroga ,&nbsp;Mohammadhasan Ghasemi ,&nbsp;Lucas Mendes Barbosa ,&nbsp;Juan Pinilla ,&nbsp;Muhammad Aqib Faizan ,&nbsp;Saman Faizollah Zadeh Ardebili ,&nbsp;Nihar Jena ,&nbsp;Wilton Gomes","doi":"10.1016/j.ihj.2025.10.008","DOIUrl":"10.1016/j.ihj.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral embolic protection devices (CEPD) have been designed to prevent embolization to the cerebral circulation during transcatheter aortic valve replacement (TAVR). However, the efficacy and safety of CEPD in stroke prevention in TAVR remains uncertain.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) comparing CEPD vs. control for patients undergoing TAVR. Risk ratios (RR) with 95 % confidence intervals (CI) were pooled with a random-effects model.</div></div><div><h3>Results</h3><div>Our meta-analysis included eight RCTs with 11,596 patients, of whom 5946 (51 %) were randomized to the CEPD group. There was no significant difference in the incidence of any stroke (3.51 % vs. 3.64 %; RR 0.91; 95 % CI 0.75–1.1; p = 0.33; I² = 0 %) between groups. Similarly, CEPD did not significantly reduce the incidence of all-cause mortality (0.82 % vs. 0.67 %; RR 1.13; 95 % CI 0.74–1.74; p = 0.57; I² = 0 %)</div></div><div><h3>Conclusions</h3><div>Among patients undergoing TAVR, CEPD did not significantly reduce stroke incidence or all-cause mortality.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 72-78"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and functional outcome of fractional flow reserve guided management of triple vessel coronary artery disease","authors":"G. Keshava Murthy ,&nbsp;A. Jayachandra ,&nbsp;Ribhu Goel ,&nbsp;J. Ratheesh Kumar ,&nbsp;Vivek Guleria ,&nbsp;R. Ananthakrishnan ,&nbsp;Inderjit Singh Monga","doi":"10.1016/j.ihj.2025.10.002","DOIUrl":"10.1016/j.ihj.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Fractional Flow Reserve (FFR) helps to assess the functional significance of a coronary stenosis accurately, particularly in triple vessel disease (TVD) where other modalities are ineffectual. There is dearth of data using FFR in TVD. In this study, we assessed outcome of FFR guided management in a spectrum of TVD.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted at four tertiary care hospitals of the armed forces between Aug 2019 and Aug 2023. Patients diagnosed with intermediate TVD on coronary angiogram (CAG) were included in the study. Initial treatment strategy based on CAG was noted. Treatment was reformulated based on FFR findings. Primary end points of death, myocardial infarction, repeat revascularization and stroke were evaluated at 3, 6 and 12 months.</div></div><div><h3>Results</h3><div>145 patients were studied. 60 % presented with acute coronary syndrome (ACS). None of the mild stenosis (30–50 %) were found to be FFR positive in any of the vessels. 4.8 % lesions in LAD, 6.2 % lesions in LCx and 2.8 % lesions in RCA were found to be functionally non-significant despite having &gt;70 % stenosis. Post FFR treatment variation was seen in 8.3 % in PCI group and surgery was averted in 33.3 % of CABG group. All-cause mortality was 3.5 %, 1.4 % had stroke and 1.4 % of patients required repeat revascularization. 83.5 % of all patients remained asymptomatic post intervention at 12 months follow-up.</div></div><div><h3>Conclusions</h3><div>FFR guided management lead to change of plan in a substantial 15.2 % of patients when compared to CAG based management. FFR negativity in LAD was the main reason for majority of TVD patients ending up with PCI instead of CABG.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 61-66"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor, “Can case control study design investigate the association of BPG levels, inflammatory cytokines with valvular dysfunction”","authors":"Sanjeev Kumar (Assistant Professor)","doi":"10.1016/j.ihj.2026.03.008","DOIUrl":"10.1016/j.ihj.2026.03.008","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Page 113"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk profile among industrial workers in North India: A cross-sectional study","authors":"Bishav Mohan,&nbsp;Akash Batta,&nbsp;Sarit Sharma,&nbsp;Tarun Satija,&nbsp;Geeti Puri Arora,&nbsp;Sarvotham Ramanathan,&nbsp;Anusha Singhania,&nbsp;Sumeet Sharma,&nbsp;Navneet Kishore,&nbsp;R.K. Soni,&nbsp;Gautam Singal,&nbsp;Anshuman Gupta,&nbsp;Rohit Tandon,&nbsp;Abhishek Goyal,&nbsp;Shibba Takkar Chhabra,&nbsp;Naved Aslam,&nbsp;Roopa Shivashankar,&nbsp;Kavita Singh,&nbsp;Meenkashi Sharma,&nbsp;Gurpreet Singh Wander","doi":"10.1016/j.ihj.2025.10.001","DOIUrl":"10.1016/j.ihj.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases (CVDs) in industrial workers are a significant but overlooked public health problem, and present study was planned to assess the prevalence of risk factors related to CVDs in industrial workers, so that active interventions can be undertaken to decrease disease burden.</div></div><div><h3>Methodology</h3><div>This cross-sectional, field-based survey was conducted among industrial workers in Ludhiana, following approval from the Institutional Ethics Committee. Random sampling of industries from the two industrial clusters was conducted, involving the collection of data on demography, migration status, anthropometric measurements, and cardiovascular risk factors by a trained task force. Quantitative data were described in terms of frequencies, range, and mean ± SD, whereas categorical data were compared by Chi square (χ2) test. A probability value less than 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Mean age of the industrial workers (<em>n</em> = 15527) was 34.95 ± 10.96 years, and 72 % of the workforce were from outside Punjab. On screening, 22 % (<em>n</em> = 3395) of the study population were hypertensive, and 4.1 % (<em>n</em> = 644) were diabetic (DM). Out of the hypertensives, 15 % (<em>n</em> = 503) were previously known to have hypertension (HT), whereas 85 % (<em>n</em> = 2892) were newly diagnosed during the study. Among previously known HT, 56 % had uncontrolled HT, and 45 % had uncontrolled diabetic status. Alcohol intake, chewing tobacco and smoking were the most common behavioral risk factors, whereas HT and DM were the most common Cardiovascular disease-related risk factors in the study population. Prevalence of HT and DM was found to be higher in native industrial workers as compared to the migrant workers. Age ≥30 years, male gender, substance abuse (alcohol and smoking) and increased BMI were significantly associated with HT and DM.</div></div><div><h3>Conclusions</h3><div>Screening of the industrial workforce for cardiovascular risk factors is imperative to decrease the risk of CVDs, and it requires a multifaceted approach that combines workplace interventions, policy changes, and individual-level support.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 55-60"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can case control study design investigate the association of BPG levels, inflammatory cytokines with valvular dysfunction","authors":"Sushma Muraraiah","doi":"10.1016/j.ihj.2026.03.006","DOIUrl":"10.1016/j.ihj.2026.03.006","url":null,"abstract":"","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Page 112"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and optical coherence tomography based morphological characteristics of coronary in-stent restenosis: A cross-sectional study","authors":"Arihant Sharma,&nbsp;Shreya Gupta,&nbsp;Ranjit K. Nath,&nbsp;Ankit Aggarwal,&nbsp;Shivani Rao,&nbsp;Puneet Aggarwal,&nbsp;B.N. Pandit","doi":"10.1016/j.ihj.2025.10.007","DOIUrl":"10.1016/j.ihj.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>In-stent restenosis (ISR), a complication after percutaneous coronary intervention (PCI), involves neointimal hyperplasia and neoatherosclerosis. With the rise of drug-eluting stents (DES), Optical Coherence Tomography (OCT) has become essential for evaluating ISR morphology and guiding treatment decisions.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the morphological patterns and clinical features of ISR in an Indian cohort using OCT, identify common morphological characteristics, and explore their relationship with ISR duration.</div></div><div><h3>Methods</h3><div>A cross-sectional observational study at a tertiary care center in New Delhi included 50 patients with angiographically confirmed ISR. OCT was used to assess qualitative and quantitative parameters of restenotic lesions, including neointimal patterns, minimal lumen area (MLA), minimal stent area (MSA), lipid content, and calcium burden. The correlation between ISR duration (early vs. late) and OCT features was also analyzed.</div></div><div><h3>Results</h3><div>The mean age was 58.08 ± 9.68 years, with 74 % male participants. Most patients (80 %) had late ISR. Hypertension (66 %) and diabetes (44 %) were the most common comorbidities, and chronic stable angina was the most frequent presentation (60 %). OCT findings showed heterogeneous neointima in 64 %, stent under-expansion in 42 %, and calcification in 82 %. Late ISR had a significantly larger neointimal area, though no other features correlated significantly with ISR duration.</div></div><div><h3>Conclusions</h3><div>Neoatherosclerosis, especially heterogeneous neointima, is the primary morphological cause of ISR in this cohort. Stent under-expansion is a key contributor. OCT is valuable for diagnosing and planning ISR interventions. Larger studies are needed for broader conclusions and standardized management.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 67-71"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-expanding or balloon-expandable transcatheter aortic valve replacement in patients with small aortic annulus: A systematic review and meta-analysis","authors":"Tanawat Attachaipanich ,&nbsp;Kotchakorn Kaewboot ,&nbsp;Suthinee Attachaipanich","doi":"10.1016/j.ihj.2025.11.002","DOIUrl":"10.1016/j.ihj.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>A small aortic annulus presents unique hemodynamic challenges during transcatheter aortic valve replacement (TAVR), increasing the risk of prosthesis-patient mismatch (PPM) and suboptimal valve performance. This study aimed to compare the efficacy and safety of self-expanding valves (SEVs) versus balloon-expandable valves (BEVs) in patients with a small aortic annulus.</div></div><div><h3>Methods</h3><div>A systematic search using 4 databases, including PubMed, Embase, Web of Science, and Cochrane CENTRAL, was conducted from inception to June 1, 2025. Studies comparing clinical outcomes of SEVs and BEVs in patients with a small aortic annulus were included.</div></div><div><h3>Results</h3><div>Thirty-eight studies involving 19,421 participants were included. No significant difference in all-cause mortality was observed between SEVs and BEVs from in-hospital to 5-year follow-up. SEVs were associated with a significantly lower risk of PPM at discharge (OR 0.34, 95 % CI 0.28–0.42), 30 days (OR 0.31, 95 % CI 0.21–0.47), and 1 year (OR 0.25, 95 % CI 0.15–0.42). However, SEVs were associated with a higher risk of in-hospital paravalvular leakage (PVL) (OR 1.95, 95 % CI 1.39–2.74), moderate-to-severe PVL (OR 2.48, 95 % CI 1.91–3.22), and permanent pacemaker implantation (PPI) both in-hospital and at 30 days. These findings remained consistent across sensitivity analyses limited to new-generation valves and propensity score-matched or randomized studies.</div></div><div><h3>Conclusions</h3><div>SEVs offer favorable hemodynamic advantages and lower risks of PPM and valve dysfunction compared to BEVs, with no difference in survival. However, these benefits must be weighed against the increased risks of PVL and PPI. Individualized valve selection remains essential to optimizing outcomes in TAVR patients.</div></div>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":"78 2","pages":"Pages 79-88"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}