Abstract
Background: Concomitant aortic stenosis (AS) and transthyretin cardiac amyloidosis (TTR-CA) in elderly population remains poorly described. Moreover, prognosis in patients with TTR-CA who undergo aortic valve replacement (AVR) is uncertain. We conducted a systematic review and meta-analysis to gain further insight. Methods: Medline, Scopus and Embase were searched from inception of these databases to May 2018 for studies reporting prevalence of TTR-CA in AS patients (surgical or trans-catheter) or prognosis of TTR-CA patients who received AVR. Pooled estimates were calculated using a random-effects model. Results: Eight studies comprising of 598 patients with AS (mean age: 75.1; males: 57.5%) were included. 63 cases had concomitant TTR-CA, with a pooled prevalence of 11.5% [6.6, 17.4]; I 2 =74%. Four studies (mean age: 76.5; males: 72.7%)] reported prognosis in patients with TTR-CA after AVR. Over a mean follow-up duration of 2.4 years, 14 of 37 patients suffered all-cause mortality (pooled incidence of mortality: 37.5% [22.8, 53.4]; I 2 =0%). Conclusion: Current meta-analysis suggests that TTR-CA in AS patients is relatively common, and has high risk of all-cause mortality after AVR. However, low event rates with wide confidence interval limit us from making conclusive statements. Further studies are needed to explore this association.
Published Version
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