CRT-700.08 The Impact of Beta Blockers on Transcatheter Aortic Valve Replacement Outcomes

Alrifai, Abdulah; Sundaravel, Swethika; Grajeda, E F Mayoral; Kabach, Mohamad; Pino, Jesus; Dayanand, Pradeep; Venegas, Eduardo; Lovitz, Lawrence; Rothenberg, Mark; Cubeddu, Roberto J.; Daniels, George E.; Heller, Eric; Faber, Cristiano; Chait, Robert; Nores, Marcos

doi:10.1016/j.jcin.2018.01.161

Cited by 1 publication

(2 citation statements)

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“…In eight observational studies that reported HRs, the pooled HR was not statistically significant, with substantial heterogeneity across studies (I 2 =77%, p<0.01). 42–44 47 57 58 73 There was a statistically significant difference between drug class (p<0.0001), however, only one study assessed each drug class: BB, CCB and diuretics compared with seven studies that assessed RAASi ( figure 4 ). From studies that conducted survival analyses, RAASi was also associated with reduced all-cause mortality with pooled HR of 0.58 (95% CI 0.43 to 0.80, p=0.006) with median follow-up ranging from 10 months to 5.8 years.…”

Section: Resultsmentioning

confidence: 95%

“…Subgroup analyses by drug class and AVR was conducted to investigate the heterogeneous results, however, substantial heterogeneity persisted, which may reflect more systematic nature of the studies, such as variability in study design, dose and duration of AHT, and length of follow-up across studies. There were some discrepant results in studies when interpreted in isolation as some studies failed to demonstrate significant outcomes, 42 61 63 65 while others were associated with improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Antihypertensive therapies in moderate or severe aortic stenosis: a systematic review and meta-analysis

et al. 2020

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BackgroundHypertension confers a poor prognosis in moderate or severe aortic stenosis (AS), however, antihypertensive therapy (AHT) is often not prescribed due to the perceived deleterious effects of vasodilation and negative inotropes.ObjectiveTo assess the efficacy and safety outcomes of AHT in adults with moderate or severe AS.DesignSystematic review and meta-analysis.Data sourcesThe Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and grey literature were searched without language restrictions up to 9 September 2019.Study eligibility criteria, appraisal and synthesis methodsTwo independent reviewers performed screening, data extraction and risk of bias assessments from a systematic search of observational studies and randomised controlled trials comparing AHT with a placebo or no AHT in adults with moderate or severe AS for any parameter of efficacy and safety outcomes. Conflicts were resolved by the third reviewer. Meta-analysis with pooled effect sizes using random-effects model, were estimated in R.Main outcome measuresMortality, Left Ventricular (LV) Mass Index, systolic blood pressure, diastolic blood pressure and LV ejection fractionResultsFrom 3025 publications, 31 studies (26 500 patients) were included in the qualitative synthesis and 24 studies in the meta-analysis. AHT was not associated with mortality when all studies were pooled, but heterogeneity was substantial across studies. The effect size of AHT differed according to drug class. Renin–angiotensin–aldosterone system inhibitors (RAASi) were associated with reduced risk of mortality (Pooled HR 0.58, 95% CI 0.43 to 0.80, p=0.006), The differences in changes of haemodynamic or echocardiographic parameters from baseline with and without AHT did not reach statistical significance.ConclusionAHT appears safe, is well tolerated. RAASi were associated with clinical benefit in patients with moderate or severe AS.

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Section: Resultsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%