Transcatheter Aortic Valve Implantation in Cardiac Amyloidosis and Aortic Stenosis

Aortic stenosis (AS) and cardiac amyloidosis (CA) occur concomitantly in a significant number of patients and portend a higher risk of all-cause mortality. Previous studies have aortic valve implantation (TAVI) versus medical therapy alone, but no evidence-based consensus regarding the ideal management of these patients has been established. Medline, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Methodologic bias was assessed using the modified NewcastleOttawa scale for observational studies. A total of 4 observational studies comprising 83 patients were included. Of these, 45 patients (54%) underwent TAVI, whereas 38 (46%) were managed conservatively. Of the 3 studies that included baseline characteristics by treatment group, 30% were women. The risk of all-cause mortality was found to be significantly lower in patients who underwent TAVI than those treated with conservative medical therapy alone (odds ratio 0.24, 95% confidence interval 0.08 to 0.73). In conclusion, this meta-analysis suggests a lower risk of all-cause mortality in patients with CA with AS who underwent TAVI than those managed with medical therapy alone.& COPY; 2023 Elsevier Inc. All rights reserved. (Am J Cardiol 2023;198:101-107)

Automated summary

A significant number of patients with concomitant aortic stenosis (AS) and cardiac amyloidosis (CA) are at higher risk of all-cause mortality. This meta-analysis suggests that patients with CA and AS who underwent transcatheter aortic valve implantation (TAVI) had a significantly lower risk of all-cause mortality compared to those managed with medical therapy alone.