Impact of Chronic Inflammatory Diseases on Clinical Outcomes in Patients undergoing Aortic Valve Replacement: A Systematic Review and Meta-analysis.

Abstract

Patients with autoimmune chronic inflammatory disease (CID) are at an increased risk of valvular heart disease, including aortic valve stenosis, insufficiency, or both. The impact of CID on the prognosis of surgical or transcatheter aortic valve replacement (AVR) remains unclear. This meta-analysis aims to evaluate the impact of CID on major clinical outcomes in this population. A comprehensive literature search of PubMed, Cochrane, and Embase databases was conducted to identify relevant studies. The primary endpoint was 30-day all-cause mortality between patients with CID and controls. Secondary endpoints included, long-term all-cause mortality, stroke and in-hospital infection. Statistical analysis included Risk Ratio (RR) with 95% confidence interval (CI) using the random-effects model. Five studies involving 572,351 patients were included in the meta-analysis. Patients with CID had a greater 30-day mortality (RR = 1.17, 95% CI: 1.09, 1.27; P < .001) and a higher rate of in-hospital infection (RR = 2.13, 95% CI: 1.03, 4.41; P < .001). No differences were observed in the other secondary endpoints. Patients with CID are at an increased risk of short-term all-cause mortality and in-hospital infections after AVR. Further studies are required to validate our results and define the optimal management of these patients.