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<p>Aortic stenosis in older adults often requires valve replacement and transcatheter aortic valve implantation (TAVI) is an option with good outcomes. However, recent hospitalizations due to heart failure (HF) may worsen results. This systematic review and meta-analysis adhering to PRISMA guidelines. We systematically searched PubMed, Cochrane Library and Scopus from database inception until July 2025. Data were analyzed by Review Manager using Risk Ratio (RRs) and 95% confidence interval (95% CIs) were used, and result was considered significant when the p-value is less than 0.05. Our primary outcome was 30-day mortality. Secondary outcomes included long-term mortality, major vascular complication, stroke, bleeding complications, pacemaker implantation, acute kidney injury (AKI) and long-term hospitalization. We included six studies, consisting of a population of 3,800 in the group with recent HF hospitalization and 12,949 in the group without recent HF hospitalization. Our pooled estimate shows a significantly higher rate of mortality in 30-day in the patients with group with recent HF hospitalization compared to the patients without recent HF hospitalization (RR: 2.28; 95% CI: [1.84–3.61]; <i>p</i> = 0.00001; I² = 40%). Among the secondary outcomes, long-term mortality (RR = 1.75; 95% CI: [1.53–2.01]; <i>p</i> &lt; 0.00001, I² = 43%), stroke (RR = 1.30; 95% CI: [1.01–1.68]; <i>p</i> = 0.04, I² = 0%), bleeding complications (RR = 1.36; 95% CI: [1.18–1.56]; <i>p</i> = 0.00001, I² = 0%), AKI (RR = 1.42; 95% CI: [1.117–1.74]; <i>p</i> = 0.0005, I² = 23%) and long-term hospitalization (RR = 1.39; 95% CI: [1.09–1.78]; <i>p</i> = 0.007, I² = 93%) were associated with higher risk in the patients with recent HF hospitalization as compared to the patients without prior HF hospitalization. While major vascular complication and pacemaker implantation were statistically insignificant. Patients with recent HF hospitalization had significantly higher 30-day mortality, long-term mortality, stroke, bleeding complications, AKI and long-term hospitalization than those without recent hospitalization.</p>

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A history that matters: a systematic review and meta-analysis on prior heart failure hospitalization and outcomes after transcatheter aortic valve implantation

  • 期刊论文

  • 发表日期：

    2026年3月30日

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  • Muhammad Ahmed,
  • Ashvin Kumar,
  • F. N. U. Ridham,
  • Insiya Fatima Azad,
  • Riya Rani Lohana,
  • Zubaida Qadir,
  • Muskan Kumari,
  • Fatima Moosani,
  • Sania Saleh,
  • Aiman Salam Shaikh,
  • Allah Dito,
  • Mahboob Alam

摘要

Aortic stenosis in older adults often requires valve replacement and transcatheter aortic valve implantation (TAVI) is an option with good outcomes. However, recent hospitalizations due to heart failure (HF) may worsen results. This systematic review and meta-analysis adhering to PRISMA guidelines. We systematically searched PubMed, Cochrane Library and Scopus from database inception until July 2025. Data were analyzed by Review Manager using Risk Ratio (RRs) and 95% confidence interval (95% CIs) were used, and result was considered significant when the p-value is less than 0.05. Our primary outcome was 30-day mortality. Secondary outcomes included long-term mortality, major vascular complication, stroke, bleeding complications, pacemaker implantation, acute kidney injury (AKI) and long-term hospitalization. We included six studies, consisting of a population of 3,800 in the group with recent HF hospitalization and 12,949 in the group without recent HF hospitalization. Our pooled estimate shows a significantly higher rate of mortality in 30-day in the patients with group with recent HF hospitalization compared to the patients without recent HF hospitalization (RR: 2.28; 95% CI: [1.84–3.61]; p = 0.00001; I² = 40%). Among the secondary outcomes, long-term mortality (RR = 1.75; 95% CI: [1.53–2.01]; p < 0.00001, I² = 43%), stroke (RR = 1.30; 95% CI: [1.01–1.68]; p = 0.04, I² = 0%), bleeding complications (RR = 1.36; 95% CI: [1.18–1.56]; p = 0.00001, I² = 0%), AKI (RR = 1.42; 95% CI: [1.117–1.74]; p = 0.0005, I² = 23%) and long-term hospitalization (RR = 1.39; 95% CI: [1.09–1.78]; p = 0.007, I² = 93%) were associated with higher risk in the patients with recent HF hospitalization as compared to the patients without prior HF hospitalization. While major vascular complication and pacemaker implantation were statistically insignificant. Patients with recent HF hospitalization had significantly higher 30-day mortality, long-term mortality, stroke, bleeding complications, AKI and long-term hospitalization than those without recent hospitalization.