Background
Methods
Protocol
Eligibility criteria
Inclusion Criteria | Exclusion Criteria | |
---|---|---|
Study type | All retrospective or prospective studies. | 1. Unfinished studies or unpublished data |
2. Reviews, editorials, letters, notes, discussions, comments, conference abstracts etc. | ||
Participants | Involved patients should conform to the following criteria: | Non-human subjects |
1. Severe aortic stenosis (orifice area < 1 cm2), severe co-morbidities that would prohibited surgery. | ||
2. Patients in need of OAC. | ||
3. Underwent diagnostic evaluation routine laboratory testing, STS score, logistic EuroSCORE, NYHA functional classification, electrocardiography, echocardiography, multislice computed tomography. | ||
Intervention | Using of at least one of NOACs | N/A |
Control | Using of at least one of VKA | N/A |
Outcome | 1. MACE | Unpublished data |
2. All-caused mortality | ||
3. Bleeding | ||
4. Disabling or nondisabling stroke | ||
5. Combined end-points |
Literature search
Study selection
Data extraction process
Assessment of heterogeneity
Synthesis of results and analysis
Risk of bias assessment
Results
Study selection
Study characteristics
Study | Age | Female | BMI | Diabetes Mellitus | ||||||
I | C | NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | |
Seeger et al., 2017 [26] | Apixaban (n = 141) | VKA (n = 131) | 82.1 (5.3) | 80.5 (6.3) | 50.4% (71) | 48.1% (63) | 27.2 (4.2) | 27.4 (5.1) | 32.6% (46) | 32.0% (42) |
Geis et al., 2018 [27] | NOAC (n = 154) | VKA (n = 172) | 83.1 (5.3) | 83.0 (4.9) | 50.6% (78) | 54.7% (94) | 26.6 (5.3) | 27.0 (5.3) | 31.0% (47) | 33% (57) |
Jochheim et al., 2019 [28] | NOAC (n = 326) | VKA (n = 636) | 81.6 (6.7) | 81.1 (6.1) | 52.1% (170) | 52.7% (335) | 26.3 (5.2) | 26.6 (4.9) | 28.8% (94) | 34.1% (217) |
Butt et al., 2019 [29] | DOAC (n = 219) | VKA (n = 516) | 83.0 (1.8) | 82.0 (2.0) | 46.1% (101) | 46.3% (239) | N/A | N/A | 17.8% (39) | 24.2% (125) |
Kalogeras et al., 2019 [31] | DOAC (n = 115) | VKA (n = 102) | 81.9 (6.3) | 82.5 (5.8) | 41% (47) | 42.2% (43) | 27.3 (5.8) | 25.9 (5.8) | 24.3% (28) | 26.8% (28) |
Kosmidou et al., 2019 [30] | NOAC (n = 155) | VKA (n = 778) | 82.8 (6.7) | 34.4% (321) | 28.4 (6.1) | 35.3% (330) | ||||
GALILEO, 2020 [32] | NOAC (n = 826) | VKA (n = 818) | 80.4 (7.1) | 80.8 (6.0) | 48.4% (400) | 50.5% (413) | 28.1 (5.5) | 28.2 (5.7) | 28.6% (236) | 28.7% (235) |
Study | Chronic Renal Failure | COPD | Coronary Heart disease | History of MI | History of Cardiac surgery | |||||
NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | |
Seeger et al., 2017 [26] | 44.7% (63) | 48.9% (64) | N/A | N/A | 66.0% (93) | 58.8% (77) | 17.7% (25) | 21.4% (28) | 12.8% (18) | 12.2% (16) |
Geis et al., 2018 [27] | N/A | N/A | N/A | N/A | 52.0% (80) | 51.0% (88) | N/A | N/A | 9.7% (15) | 8.0% (13) |
Jochheim et al. 2019 [28] | 53.3% (174) | 44.3% (282) | 20.6% (67) | 21.9% (139) | N/A | N/A | 14.1% (45) | 15.4% (94) | 8.9% (29) | 12.1% (77) |
Butt et al., 2019 [29] | 5.9% (13) | 14.2% (73) | 21.0% (46) | 16.9% (87) | N/A | N/A | N/A | N/A | N/A | N/A |
Kalogeras et al., 2019 [31] | N/A | N/A | N/A | N/A | N/A | N/A | 14.8% (17) | 10.3% (11) | 71.3% (82) | 46.1% (47) |
Kosmidou et al.,2019 [30] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
GALILEO, 2020 [32] | N/A | N/A | 13.3% (110) | 10.8% (88) | 39.3% (325) | 37.3% (305) | N/A | N/A | N/A | N/A |
Study | Recent PCI | Haemoglobin pre-TAVI/g/dl | Aortic Valve Area cm2 | Peripheral or cerebral vascular disease | History of stroke or intracerebral bleeding | |||||
NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | |
Seeger et al., 2017 [26] | N/A | N/A | N/A | N/A | N/A | N/A | 82.9% (117) | 88.5% (116) | 11.3% (16) | 14.5% (19) |
Geis et al., 2018 [27] | 1.0% (2) | 1.0% (2) | 12.1 (1.8) | 11.8 (1.6) | 0.7 (0.2) | 0.7 (0.2) | N/A | N/A | 16.0% (24) | 15.0% (25) |
Jochheim et al. 2019 [28] | 32.5% (106) | 29.9% (190) | 12.2 (1.8) | 12.3 (1.9) | 0.7 (0.2) | 0.7 (0.2) | 4.0% (13) | 11.5% (73) | 20.6% (67) | 21.9% (139) |
Butt et al., 2019 [29] | N/A | N/A | N/A | N/A | N/A | N/A | 10.1% (22) | 8.9% (46) | 24.7% (54) | 15.1% (78) |
Kalogeras et al., 2019 [31] | 27% (31) | 23.5% (24) | N/A | N/A | 0.68 (0.30) | 0.67 (0.29) | N/A | N/A | 40.2% (41) | 31.3% (36) |
Kosmidou et al.,2019 [30] | 49.1% (458) | N/A | N/A | 22% (206) | 22.0% (205) | |||||
GALILEO, 2020 [32] | N/A | N/A | N/A | N/A | 1.8 (0.6) | 1.9 (0.5) | 10.0% (83) | 10.0% (82) | 6.2% (51) | 4.3% (35) |
Study | Atrial Fibrillation | Hypertension | CHA2DS2-VASc Score | STS Score for mortality | Ejection Fraction≤50% | |||||
NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | |
Seeger et al., 2017 [26] | 100% (141) | 100% (131) | N/A | N/A | 5.0 (1.2) | 4.9 (1.1) | 7.5 (5.2) | 7.9 (6.3) | N/A | N/A |
Geis et al., 2018 [27] | 94.0% (145) | 94.0% (161) | 95% (147) | 92% (158) | 4.6 (1.2) | 4.8 (1.3) | 4.1 (1.9) | 4.4 (2.4) | 29% (44) | 33.0% (57) |
Jochheim et al. 2019 [28] | 62.0% (202) | 75.2% (478) | 89.9% (293) | 89.5% (569) | ≥2:93.6% (n = 305) | ≥2: 96.1% (n = 611) | 4.5 (1.1) | 4.5 (1.1) | 39.9% (130) | 39.3% (250) |
Butt et al., 2019 [29] | 100% (219) | 100% (516) | 87.2% (191) | 88.6% (457) | 5.0 (1.4) | 4.0 (1.3) | N/A | N/A | N/A | N/A |
Kalogeras et al., 2019 [31] | 68.7% (79) | 59.8% (61) | N/A | N/A | N/A | N/A | N/A | N/A | 9.6% (11) | 3.9% (4) |
Kosmidou et al.,2019 [30] | 100% (933) | 91.7% (856) | 5.6 (1.3) | 8.2 (4.2) | N/A | |||||
GALILEO, 2020 [32] | 10.4% (87) | 11.3% (94) | 87.2% (720) | 85.2% (697) | 4.5 (1.3) | 4.6 (1.2) | 4.0 (3.2) | 4.3 (3.5) | 57.4 (11.2)a | 58.2 (11.2)1 |
Study | All-Cause Mortality | Bleeding | Disabling and nondiasbling stroke | Combined end-pointa | Stroke at early follow-up (30-day) | |||||
---|---|---|---|---|---|---|---|---|---|---|
NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | NOAC | VKA | |
Seeger et al., 2017 [26] | 19 (81) | 6 (50) | 5 (81) | 7 (50) | 1 (81) | 1 (50) | 22 (81) | 9 (50) | 3 (141) | 7 (131) |
Geis et al., 2018 [27] | 12 (154) | 11 (172) | 3 (154) | 3 (172) | 5 (154) | 2 (172) | 17 (154) | 14 (172) | N/A | N/A |
Jochheim et al., 2019 [28] | 47 (326) | 70 (636) | 69 (326) | 146 (636) | 10 (326) | 13 (636) | 63 (326) | 87 (636) | 5 (326) | 6 (636) |
Butt et al., 2019 [29] | 15 (99) | 54 (357) | 11 (94) | 28 (343) | 8 (93) | 14 (346) | N/A | N/A | 0 (213) | 3 (516) |
Kalogeras et al., 2019 [31] | 13 (115) | 16 (102) | 6 (115) | 9 (102) | N/A | N/A | N/A | N/A | N/A | N/A |
Kosmidou et al., 2019 [30] | 33 (155) | 207 (778) | 8 (155) | 43 (778) | 12 (155) | 41 (778) | N/A | N/A | N/A | N/A |
GALILEO, 2020 [32] | 64 (826) | 38 (818) | 46 (826) | 31 (818) | 30 (826) | 25 (818) | 83 (826) | 68 (818) | N/A | N/A |