Clinical outcomes of transcatheter aortic valve implantation in oncology versus non-oncology patients with severe aortic stenosis: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONG Yumeng ¹ , CHANG Tianqi ¹ , GU Yiyu ¹ , XU Yinan ¹ , ZHANG Mingyang ¹ , WANG Yutong ¹ ,  JIANG Tingbo ²

1. The First Clinical Medical College of Soochow University, Suzhou, 215006, Jiangsu, P. R. China;
2. Department of Cardiovascular Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, P. R. China;

Corresponding author：

JIANG Tingbo, Email: jiangtingbo6797@163.com

Keywords：

Severe aortic stenosis; oncology; transcatheter aortic valve implantation; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202102066

Video：

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Objective To compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) in oncology and non-oncology patients with severe aortic stenosis (AS).Methods A computer-based search in PubMed, The Cochrane Library, EMbase, CBM, CNKI and Wanfang databases from their date of inception to December 2021 was performed, together with reference screening, to identify eligible clinical trials. Two investigators screened the articles, extracted data, and evaluated quality independently. RevMan 5.3 and Stata 12.0 softwares were used for meta-analysis.Results The selected 8 cohort studies contained 57 988 patients, including 12 335 cancer patients and 45 653 non-cancer patients. The results of meta-analysis showed that in patients with cancer, the 30-day mortality [OR=0.74, 95%CI (0.65, 0.84), I²=0%, P<0.000 01], stroke [OR=0.87, 95%CI (0.76, 0.99), I²=0%, P=0.04] and acute kidney injury [OR=0.81, 95%CI (0.76, 0.85), I²=49%, P<0.000 01] were lower than those in patients without cancer. The 1-year mortality [OR=1.46, 95%CI (1.15, 1.86), I²=62%, P=0.002] and late mortality [OR=1.51, 95%CI (1.24, 1.85), I²=61%, P<0.000 1] were higher in patients with cancer.Conclusion It is effective and safe in cancer patients with severe AS undergoing TAVI. However, compared with patients without cancer, it is still high in long-term mortality, and further study of the role of TAVI in cancer patients with AS is necessary.

Citation： SONG Yumeng, CHANG Tianqi, GU Yiyu, XU Yinan, ZHANG Mingyang, WANG Yutong, JIANG Tingbo. Clinical outcomes of transcatheter aortic valve implantation in oncology versus non-oncology patients with severe aortic stenosis: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(5): 634-641. doi: 10.7507/1007-4848.202102066 Copy

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2.	吴永健, 许海燕. 探索经导管主动脉瓣置换术的中国特色康复模式. 中华老年心脑血管病杂志, 2019, 21(7): 673-675.
3.	Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med, 2010, 363(17): 1597-1607.
4.	Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med, 2011, 364(23): 2187-2198.
5.	王圣, 黄乾海, 陈现杰, 等. 经导管主动脉瓣置入术后常见并发症及处理措施. 心肺血管病杂志, 2019, 38(5): 584-587.
6.	党梦秋, 范嘉祺, 朱齐丰, 等. 《经导管主动脉瓣置换术中国专家共识(2020更新版)》解读. 心电与循环, 2021, 40(1): 1-5.
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9.	冯晔子, 张申伟, 马倩倩, 等. 主动脉瓣重度狭窄经导管主动脉瓣置换术后患者围术期效果观察. 心肺血管病杂志, 2019, 38(11): 1146-1149.
10.	Landes U, Iakobishvili Z, Vronsky D, et al. Transcatheter aortic valve replacement in oncology patients with severe aortic stenosis. JACC Cardiovasc Interv, 2019, 12(1): 78-86.
11.	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials, 1996, 17(1): 1-12.
12.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
13.	Berkovitch A, Guetta V, Barbash IM, et al. Favorable short-term and long-term outcomes among patients with prior history of malignancy undergoing transcatheter aortic valve implantation. J Invasive Cardiol, 2018, 30(3): 105-109.
14.	Mangner N, Woitek FJ, Haussig S, et al. Impact of active cancer disease on the outcome of patients undergoing transcatheter aortic valve replacement. J Interv Cardiol, 2018, 31(2): 188-196.
15.	Watanabe Y, Kozuma K, Hioki H, et al. Comparison of results of transcatheter aortic valve implantation in patients with versus without active cancer. Am J Cardiol, 2016, 118(4): 572-577.
16.	Biancari F, Dahlbacka S, Juvonen T, et al. Favorable outcome of cancer patients undergoing transcatheter aortic valve replacement. Int J Cardiol, 2020, 315: 86-89.
17.	Guha A, Dey AK, Arora S, et al. Contemporary trends and outcomes of percutaneous and surgical aortic valve replacement in patients with cancer. J Am Heart Assoc, 2020, 9(2): e014248.
18.	Tabata N, Al-Kassou B, Sugiura A, et al. Prognostic impact of cancer history in patients undergoing transcatheter aortic valve implantation. Clin Res Cardiol, 2020, 109(10): 1243-1250.
19.	Tabata N, Al-Kassou B, Sugiura A, et al. Predictive value of the platelet-to-lymphocyte ratio in cancer patients undergoing transcatheter aortic valve replacement. JACC CardioOncol, 2019, 1(2): 159-169.
20.	Zamorano JL, Lancellotti P, Muñoz DR, et al. 2016 ESC position paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Kardiol Pol, 2016, 74(11): 1193-1233.
21.	Cubeddu RJ, Jneid H, Don CW, et al. Retrograde versus antegrade percutaneous aortic balloon valvuloplasty: Immediate, short- and long-term outcome at 2 years. Catheter Cardiovasc Interv, 2009, 74(2): 225-231.
22.	Lieberman EB, Bashore TM, Hermiller JB, et al. Balloon aortic valvuloplasty in adults: Failure of procedure to improve long-term survival. J Am Coll Cardiol, 1995, 26(6): 1522-1528.
23.	Yusuf SW, Sarfaraz A, Durand JB, et al. Management and outcomes of severe aortic stenosis in cancer patients. Am Heart J, 2011, 161(6): 1125-1132.
24.	Samuels LE, Kaufman MS, Morris RJ, et al. Open heart surgery in patients with chronic lymphocytic leukemia. Leuk Res, 1999, 23(1): 71-75.
25.	Chan J, Rosenfeldt F, Chaudhuri K, et al. Cardiac surgery in patients with a history of malignancy: Increased complication rate but similar mortality. Heart Lung Circ, 2012, 21(5): 255-259.
26.	Van Mieghem NM, van der Boon RM, Nuis RJ, et al. Cause of death after transcatheter aortic valve implantation. Catheter Cardiovasc Interv, 2014, 83(7): E277-E282.
27.	Kogoj P, Devjak R, Bunc M. Balloon aortic valvuloplasty (BAV) as a bridge to aortic valve replacement in cancer patients who require urgent non-cardiac surgery. Radiol Oncol, 2014, 48(1): 62-66.

1. Iung B, Vahanian A. Epidemiology of acquired valvular heart disease. Can J Cardiol, 2014, 30(9): 962-970.
2. 吴永健, 许海燕. 探索经导管主动脉瓣置换术的中国特色康复模式. 中华老年心脑血管病杂志, 2019, 21(7): 673-675.
3. Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med, 2010, 363(17): 1597-1607.
4. Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med, 2011, 364(23): 2187-2198.
5. 王圣, 黄乾海, 陈现杰, 等. 经导管主动脉瓣置入术后常见并发症及处理措施. 心肺血管病杂志, 2019, 38(5): 584-587.
6. 党梦秋, 范嘉祺, 朱齐丰, 等. 《经导管主动脉瓣置换术中国专家共识(2020更新版)》解读. 心电与循环, 2021, 40(1): 1-5.
7. 经导管主动脉瓣置换术中国专家共识编写组. 经导管主动脉瓣置换术中国专家共识. 中国介入心脏病学杂志, 2015, 23(12): 661-667.
8. Bekeredjian R, Krumsdorf U, Chorianopoulos E, et al. Usefulness of percutaneous aortic valve implantation to improve quality of life in patients >80 years of age. Am J Cardiol, 2010, 106(12): 1777-1781.
9. 冯晔子, 张申伟, 马倩倩, 等. 主动脉瓣重度狭窄经导管主动脉瓣置换术后患者围术期效果观察. 心肺血管病杂志, 2019, 38(11): 1146-1149.
10. Landes U, Iakobishvili Z, Vronsky D, et al. Transcatheter aortic valve replacement in oncology patients with severe aortic stenosis. JACC Cardiovasc Interv, 2019, 12(1): 78-86.
11. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials, 1996, 17(1): 1-12.
12. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
13. Berkovitch A, Guetta V, Barbash IM, et al. Favorable short-term and long-term outcomes among patients with prior history of malignancy undergoing transcatheter aortic valve implantation. J Invasive Cardiol, 2018, 30(3): 105-109.
14. Mangner N, Woitek FJ, Haussig S, et al. Impact of active cancer disease on the outcome of patients undergoing transcatheter aortic valve replacement. J Interv Cardiol, 2018, 31(2): 188-196.
15. Watanabe Y, Kozuma K, Hioki H, et al. Comparison of results of transcatheter aortic valve implantation in patients with versus without active cancer. Am J Cardiol, 2016, 118(4): 572-577.
16. Biancari F, Dahlbacka S, Juvonen T, et al. Favorable outcome of cancer patients undergoing transcatheter aortic valve replacement. Int J Cardiol, 2020, 315: 86-89.
17. Guha A, Dey AK, Arora S, et al. Contemporary trends and outcomes of percutaneous and surgical aortic valve replacement in patients with cancer. J Am Heart Assoc, 2020, 9(2): e014248.
18. Tabata N, Al-Kassou B, Sugiura A, et al. Prognostic impact of cancer history in patients undergoing transcatheter aortic valve implantation. Clin Res Cardiol, 2020, 109(10): 1243-1250.
19. Tabata N, Al-Kassou B, Sugiura A, et al. Predictive value of the platelet-to-lymphocyte ratio in cancer patients undergoing transcatheter aortic valve replacement. JACC CardioOncol, 2019, 1(2): 159-169.
20. Zamorano JL, Lancellotti P, Muñoz DR, et al. 2016 ESC position paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Kardiol Pol, 2016, 74(11): 1193-1233.
21. Cubeddu RJ, Jneid H, Don CW, et al. Retrograde versus antegrade percutaneous aortic balloon valvuloplasty: Immediate, short- and long-term outcome at 2 years. Catheter Cardiovasc Interv, 2009, 74(2): 225-231.
22. Lieberman EB, Bashore TM, Hermiller JB, et al. Balloon aortic valvuloplasty in adults: Failure of procedure to improve long-term survival. J Am Coll Cardiol, 1995, 26(6): 1522-1528.
23. Yusuf SW, Sarfaraz A, Durand JB, et al. Management and outcomes of severe aortic stenosis in cancer patients. Am Heart J, 2011, 161(6): 1125-1132.
24. Samuels LE, Kaufman MS, Morris RJ, et al. Open heart surgery in patients with chronic lymphocytic leukemia. Leuk Res, 1999, 23(1): 71-75.
25. Chan J, Rosenfeldt F, Chaudhuri K, et al. Cardiac surgery in patients with a history of malignancy: Increased complication rate but similar mortality. Heart Lung Circ, 2012, 21(5): 255-259.
26. Van Mieghem NM, van der Boon RM, Nuis RJ, et al. Cause of death after transcatheter aortic valve implantation. Catheter Cardiovasc Interv, 2014, 83(7): E277-E282.
27. Kogoj P, Devjak R, Bunc M. Balloon aortic valvuloplasty (BAV) as a bridge to aortic valve replacement in cancer patients who require urgent non-cardiac surgery. Radiol Oncol, 2014, 48(1): 62-66.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical outcomes of transcatheter aortic valve implantation in oncology versus non-oncology patients with severe aortic stenosis: A systematic review and meta-analysis

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