曾接受过胸部放射治疗的癌症幸存者经导管主动脉瓣置换术后的疗效:最新系统综述和荟萃分析。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Farah Yasmin, Abdul Moeed, Muhammad Tanveer Alam, Vikash Virwani, Yumna Khabir, Asim Shaikh, Apurva V Vyas, M Chadi Alraies
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引用次数: 0

摘要

曾接受过胸部放射治疗(C-XRT)的癌症幸存者在出现无症状主动脉瓣狭窄时接受 TAVR 的临床结果在主要临床试验中未得到充分评估,导致结果相互矛盾。因此,我们进行了这项荟萃分析,以评估曾接受过 C-XRT 的癌症幸存者接受 TAVR 的安全性、有效性和死亡率。我们检索了截至 2024 年 3 月的 MEDLINE 和 Scopus。筛选出了观察性研究和随机对照试验,这些研究比较了接受 TAVR 的重度主动脉瓣狭窄患者接受 C-XRT 和未接受 C-XRT 的情况,并得出了至少一项相关结果。采用随机效应模型对数据进行分析,得出加权平均差、风险比和 95% 置信区间。共纳入六项研究,6,191 名患者(278 名 C-XRT 患者和 5,913 名非 C-XRT 患者)。30天(RR 1.63,p = 0.12)和1年(RR 1.59,p = 0.08)的全因死亡率显示,先行C-XRT与未行C-XRT无显著差异。CHF恶化是既往接受过C-XRT(RR 1.98,p = 0.0004)与未接受过C-XRT的患者术后安全性显著较高的唯一结果。疗效终点,即 LVEF 改善(MD 1.24;-0.50,2.98)和主动脉瓣坡度(MD -0.63;-1.32,0.05)没有明显差异。在既往接受过C-XRT治疗和未接受过C-XRT治疗的癌症幸存者中,TAVR具有相似的全因死亡率、疗效和安全性(除CHF恶化外)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes after transcatheter aortic valve replacement in cancer survivors with prior chest radiation therapy: an updated systematic review and meta-analysis.

Clinical outcomes for TAVR in cancer survivors with prior chest radiation therapy (C-XRT) who develop symptomatic aortic-valve stenosis are not adequately assessed in major clinical trials leading to conflicting results. Hence, we conducted this meta-analysis to evaluate the, safety, efficacy, and mortality outcomes of cancer survivors with prior C-XRT undergoing TAVR. MEDLINE and Scopus were searched up to March 2024. Observational studies and randomized controlled trials comparing severe aortic stenosis patients with and without prior C-XRT undergoing TAVR with at least one outcome of interest were shortlisted. Data were analyzed using random-effects model to derive weighted mean differences, and risk ratios with 95% confidence intervals. Six studies with 6,191 patients (278 C-XRT and 5,913 no-C-XRT) were included. All-cause mortality at 30-day (RR 1.63, p = 0.12) and 1-year interval (RR 1.59, p = 0.08) showed no significant differences with prior C-XRT versus no-C-XRT. Worsening CHF was the only post-procedural safety outcome significantly higher in patients with prior C-XRT (RR 1.98, p = 0.0004) versus no- C-XRT. The efficacy end-points i.e., improvement in LVEF (MD 1.24; -0.50, 2.98), and aortic valve gradient (MD -0.63; -1.32, 0.05) were not significantly different. TAVR has similar all-cause mortality, efficacy and safety (except CHF worsening) among cancer survivors with and without a prior history of C-XRT.

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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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