Statins and Mortality of Patients After Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-analysis

Abstract

While TAVI is widely used, optimal medical therapy to reduce the mortality rate after transcatheter aortic valve implantation (TAVI) is still unclear. We performed a systematic review and meta-analysis to evaluate the impact of statins on mortality following TAVI. Present systematic review of the literature was performed using Medline, Embase, Scopus, and Web of Science; all studies reported all-cause mortality in patients who underwent TAVI and received or did not receive statin therapy. Data were analyzed using random-effects models. Seventeen articles (21 380 patients) were included in the meta-analysis. Statin therapy was associated with a reduction of all-cause mortality (Hazard ratio [HR] = .78, 95% Confidence interval [CI] .68–.89, P < .001). Moderate between-study heterogeneity was observed (I2 = 45.2). High-intensity statin therapy was more effective than low or moderate intensity statin therapy in reduction of all-cause mortality (Risk ratio [RR] = .62, 95% CI 0.45–.85, P = .003, I2 = .0). Statin therapy could reduce the mid-term all-cause mortality rate following TAVI. However, all included studies were observational and, therefore, randomized controlled trials are still needed to assess the effect of statin therapy on mortality after TAVI.

Lipoprotein (a) and lipid-lowering treatment from the perspective of a cardiac surgeon. An impact on the prognosis in patients with aortic valve replacement and after heart transplantation

“…Based on information from Refs. [ [1] , [2] , [3] , [4] , [5] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [32] , [33] , [34] , [35] , [36] , [37] , [44] , [45] , [46] , [47] , [48] , [49] , [50] ]. The elements of the figure were created using SERVIER MEDICAL ART (CC BY 4.0).…”

“…The use of statins in patients undergoing TAVI contributes to overall all-cause mortality risk reduction (HR = 0.78; 95 % CI: 0.68–0.89), which is more pronounced with the intensive statin therapy (HR = 0.62; 95 % CI: 0.45–0.85) [ 23 ]. It was also shown that the use of statins in patients undergoing SAVR reduced the risk of all-cause mortality (HR = 0.67; 95 % CI: 0.60–0.74).…”