Jiménez-Xarrié Elena, Asmarats Lluis, Roqué-Figuls Marta, Millán Xavier, Li Chi Hion Pedro, Fernández-Peregrina Estefanía, Sánchez-Ceña Juan, Massó van Roessel Albert, Maestre Hittinger M Luz, Paniagua Pilar, Arzamendi Dabit
Cardiology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute (IIB Sant Pau), 08025 Barcelona, Spain.
Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain.
J Clin Med. 2023 Sep 18;12(18):6025. doi: 10.3390/jcm12186025.
Transcatheter aortic valve replacement (TAVR) is currently the treatment of choice for patients aged ≥75 years with severe aortic stenosis. Preoperative anemia is present in a large proportion of patients and may increase the risk of post-procedural complications. The purpose of this prognostic systematic review was to analyze the impact of baseline anemia on short- and mid-term outcomes following TAVR. A computerized search was performed on PubMed and Web of Science databases for studies published between January 2013 and December 2022. Primary outcomes were 30-day need for transfusion, acute renal failure, 30-day and mid-term mortality, and readmission during the first year post-TAVR. Data were analyzed via random effects model using inverse variance method with 95% confidence intervals. Eleven observational studies met our eligibility criteria and included a total of 12,588 patients. The prevalence of baseline anemia ranged between 39% and 72%, with no relevant sex differences. Patients with preprocedural anemia received more blood transfusions [OR: 2.95 (2.13-4.09)]), and exhibited increased rates of acute kidney injury [OR:1.74 (1.45-2.10)], short-term mortality [OR: 1.47 (1.07-2.01], and mid-term [OR: 1.89 (1.58-2.25)] mortality following TAVR compared with those without anemia. Baseline anemia determined an increased risk for blood transfusion, acute kidney injury, and short/mid-term mortality among TAVR recipients.
经导管主动脉瓣置换术（TAVR）目前是年龄≥75岁的重度主动脉瓣狭窄患者的首选治疗方法。术前贫血在很大一部分患者中存在，可能会增加术后并发症的风险。本预后系统评价的目的是分析基线贫血对TAVR术后短期和中期结局的影响。在PubMed和Web of Science数据库中进行计算机检索，以查找2013年1月至2022年12月发表的研究。主要结局包括术后30天输血需求、急性肾衰竭、30天和中期死亡率以及TAVR术后第一年再次入院情况。采用随机效应模型，通过逆方差法分析数据，置信区间为95%。11项观察性研究符合我们的纳入标准，共纳入12588例患者。基线贫血的患病率在39%至72%之间，无明显性别差异。与无贫血患者相比，术前贫血患者接受更多输血[比值比（OR）：2.95（2.13 - 4.09）]，急性肾损伤发生率增加[OR：1.74（1.45 - 2.10）]，短期死亡率[OR：1.47（1.07 - 2.01）]和中期死亡率[OR：1.89（1.58 - 2.25）]也更高。基线贫血决定了TAVR接受者输血、急性肾损伤和短期/中期死亡的风险增加。
