未经证实:尽管清楚地概述了严重症状性主动脉瓣狭窄(AS)的主动脉瓣置换术,手术干预在无症状重度AS中的作用尚不清楚,证据有限.我们的荟萃分析的目的是评估早期外科主动脉瓣修复术与保守治疗相比的有效性和安全性。
UNASSIGNED:在PubMed中进行了系统的文献检索,Scopus,Embase和Cochrane数据库用于比较无症状主动脉瓣狭窄患者早期手术与保守治疗的研究。未调整的优势比(OR)使用随机效应模型进行汇总,P值<0.05被认为具有统计学意义。
UNASSIGNED:共纳入5篇文章(3项观察性研究和2项随机对照试验)。中位随访时间为4.1年,全因死亡率的几率显着降低[OR=0.30(95CI:0.17-0.53),p<0.0001],心血管死亡率[OR=0.35(95CI:(0.17-0.72),p=0.005],和心源性猝死(OR=0.36(95CI:0.15-0.89),与保守治疗相比,早期手术组的p=0.03)。大出血的发生率之间没有显着差异。临床血栓栓塞事件,因心力衰竭住院,保守治疗组和早期手术组之间的卒中和心肌梗死。
未经证实:在无症状AS患者中,与保守治疗方法相比,早期手术在降低全因死亡率和心血管死亡率方面显示出更好的结局.
UNASSIGNED: Although aortic valve replacement in severe symptomatic Aortic Stenosis (AS) are clearly outlined, the role of surgical intervention in asymptomatic severe AS remains unclear with limited evidence. The aim of our meta-analysis is to evaluate the efficacy and safety of early surgical aortic valve repair compared to conservative management.
UNASSIGNED: A systematic literature search was performed in PubMed, Scopus, Embase and Cochrane databases for studies comparing the early surgery versus conservative management among asymptomatic aortic stenosis patients. Unadjusted odds ratios (OR) were pooled using a random-effect model, and a p-value of < 0.05 was considered statistically significant.
UNASSIGNED: A total of 5 articles (3 observational studies and 2 randomized controlled trials) were included. At a median followup of 4.1 years, here were significantly lower odds of all-cause mortality [OR = 0.30 (95 %CI:0.17-0.53), p < 0.0001], cardiovascular mortality [OR = 0.35 (95 %CI:(0.17-0.72), p = 0.005], and sudden cardiac death (OR = 0.36 (95 %CI: 0.15-0.89), p = 0.03) among early surgery group compared with conservative care. There was no significant difference between incidence of major bleeding, clinical thromboembolic events, hospitalization due to heart failure, stroke and myocardial infarction between the conservative care groups and early surgery.
UNASSIGNED: Among asymptomatic patients with AS, early surgery shows better outcomes in reducing all-cause mortality and cardiovascular mortality compared with conservative management approaches.