TY - JOUR
T1 - LONG-TERM SYSTEMIC BLOOD PRESSURE AFTER ENDOVASCULAR STENTING OF AORTIC COARCTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS
AU - Meijs, Timion
AU - Warmerdam, Evangeline
AU - Slieker, Martijn
AU - Krings, Gregor
AU - Molenschot, Mirella
AU - Meijboom, Folkert
AU - Sieswerda, Gertjan
AU - Doevendans, Pieter
AU - Bouma, Berto
AU - de Winter, Robbert
AU - Mulder, Barbara
AU - Voskuil, Michiel
PY - 2019/3/12
Y1 - 2019/3/12
N2 - Background
Although stent implantation for aortic coarctation (CoA) is associated with acute anatomical and hemodynamic benefit, limited evidence exists regarding the late impact on blood pressure and cardiovascular complications. In this meta-analysis we aimed to evaluate the influence of stent placement for CoA on long-term systemic blood pressure.
Methods
PubMed, EMBASE, and Cochrane Library were searched to identify studies reporting on mean systolic blood pressure (SBP) before and at least 12 months after stent implantation. Meta-analysis was performed on the absolute change from baseline to last follow-up using a random-effects model.
Results
Twenty-six studies with a total of 1,157 patients were included for final analysis. Meta-analysis showed a 20.3 mmHg (95% confidence interval (CI) 16.4-24.1 mmHg; P < 0.00001) reduction in SBP. Previous CoA correction, age < 18 years, and lower baseline SBP were identified as risk factors for a less significant decrease in SBP. A concomitant 8.2 mmHg (12 studies; 95% CI 5.2-11.3 mmHg; P < 0.00001) reduction in diastolic blood pressure (DBP) was observed. Sensitivity analyses and adjustment for suspected publication bias did not modify the overall outcome.
Conclusion
Endovascular stenting as a treatment for CoA is associated with a significant decline in both SBP and DBP during long-term follow-up and may consequently reduce the risk of future adverse cardiovascular events.
AB - Background
Although stent implantation for aortic coarctation (CoA) is associated with acute anatomical and hemodynamic benefit, limited evidence exists regarding the late impact on blood pressure and cardiovascular complications. In this meta-analysis we aimed to evaluate the influence of stent placement for CoA on long-term systemic blood pressure.
Methods
PubMed, EMBASE, and Cochrane Library were searched to identify studies reporting on mean systolic blood pressure (SBP) before and at least 12 months after stent implantation. Meta-analysis was performed on the absolute change from baseline to last follow-up using a random-effects model.
Results
Twenty-six studies with a total of 1,157 patients were included for final analysis. Meta-analysis showed a 20.3 mmHg (95% confidence interval (CI) 16.4-24.1 mmHg; P < 0.00001) reduction in SBP. Previous CoA correction, age < 18 years, and lower baseline SBP were identified as risk factors for a less significant decrease in SBP. A concomitant 8.2 mmHg (12 studies; 95% CI 5.2-11.3 mmHg; P < 0.00001) reduction in diastolic blood pressure (DBP) was observed. Sensitivity analyses and adjustment for suspected publication bias did not modify the overall outcome.
Conclusion
Endovascular stenting as a treatment for CoA is associated with a significant decline in both SBP and DBP during long-term follow-up and may consequently reduce the risk of future adverse cardiovascular events.
U2 - 10.1016/S0735-1097(19)31206-9
DO - 10.1016/S0735-1097(19)31206-9
M3 - Meeting Abstract
SN - 0735-1097
VL - 73
SP - 598
EP - 598
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 9
ER -