Abstract 11271: Post TAVR Outcomes Among Patient With Amyloidosis and Aortic Stenosis: A Meta Analysis

Abstract

Introduction: Aortic stenosis (AS) is one of the most prevalent valvular heart diseases globally. As many as 16% of AS patients have underlying cardiac amyloidosis (CA). To date, there is a paucity of data on outcomes among AS with concomitant CA patients post-TAVR. Hypothesis: This study aimed to evaluate the clinical outcomes post TAVR among patients with CA. Methods: We performed a systematic literature search of databases for relevant articles from inception until June 01, 2022. Unadjusted odds ratios (OR) were pooled using a random-effect model, and a p-value of <0.05 was considered statistically significant. Results: 5 studies with 1,488 patients were involved in the final analysis. The mean age of patients among CA+AS and AS alone was (85 vs 80) years. The number of males affected with dual pathology was higher compared to AS alone (71% vs 59%). 29% of patients were having a right bundle branch block in the CA+AS group, while 12% were among AS alone. Mean IV Septal Thickness (1.53 vs 1.33), mean relative wall thickness (0.60 vs 0.40) and mean LA dimensions (5.19 vs 4.8) were higher among the CA+AS group compared with AS alone. At the mean follow up of 12 months the odds of in-hospital mortality (OR, 2.09(95% CI: 0.77-5.63), P = 0.15), stroke (OR, 0.46(95%CI: 0.06-3.60), P = 0.46), and vascular complication (OR, 0.19(95% CI: 0.01-3.40), P = 0.26) were comparable between both group. In contrast, the incidence of acute kidney injury (OR, 3.09(95% CI: 2.02-4.71), P<0.001), and major bleeding (OR, 1.74(95% CI: 1.02-2.98), P = 0.04) were significantly higher among CA+AS group compared to AS group following TAVR. Conclusions: TAVR appeared to be a safe procedure among patients diagnosed with amyloidosis in aortic stenosis with a similar mortality rate between both groups of patients. Further studies should aim at determining the optimal valve replacement strategy in AS patients with concomitant CA.