Association of frailty status with acute kidney injury and mortality after transcatheter aortic valve replacement: A systematic review and meta-analysisReport as inadecuate




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Objective

Frailty is a common condition in patients with severe aortic stenosis AS undergoing transcatheter aortic valve replacement TAVR. The aim of this systematic review was to assess the impact of frailty status on acute kidney injury AKI and mortality after TAVR.

Methods

A systematic literature search was conducted using MEDLINE, EMBASE, and Cochrane databases from the inception through November 2016. The protocol for this study is registered with PROSPERO International Prospective Register of Systematic Reviews; no. CRD42016052350. Studies that reported odds ratios, relative risks or hazard ratios comparing the risk of AKI after TAVR in frail vs. non-frail patients were included. Mortality risk was evaluated among the studies that reported AKI-related outcomes. Pooled risk ratios RR and 95% confidence interval CI were calculated using a random-effect, generic inverse variance method.

Results

Eight cohort studies with a total of 10,498 patients were identified and included in the meta-analysis. The pooled RR of AKI after TAVR among the frail patients was 1.19 95% CI 0.97–1.46, I2 = 0, compared with non-frail patients. When the meta-analysis was restricted only to studies with standardized AKI diagnosis according to Valve Academic Research Consortium VARC-2 criteria, the pooled RRs of AKI in frail patients was 1.16 95% CI 0.91–1.47, I2 = 0. Within the selected studies, frailty status was significantly associated with increased mortality RR 2.01; 95% CI 1.44–2.80, I2 = 58.

Conclusion

The findings from our study suggest no significant association between frailty status and AKI after TAVR. However, frailty status is associated with mortality after TAVR and may aid appropriate patient selection for TAVR.



Author: Charat Thongprayoon , Wisit Cheungpasitporn , Natanong Thamcharoen, Patompong Ungprasert, Wonngarm Kittanamongkolchai, Michael A.

Source: http://plos.srce.hr/



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