Valvular & structural heart disease

Stroke reduction by cerebral embolic protection devices in transcatheter aortic valve implantation: a systematic review and Bayesian meta-analysis

HeartPublished Systematic review and Bayesian meta-analysis of randomised trials

Pooled result · Disabling strokeResult — go to the resultMedian relative risk 0.56 95% CrI 0.28–1.19

Authors' conclusion

There is a high probability of a beneficial CEP treatment effect, but this is unlikely to be clinically relevant.

Study context

Population
Patients undergoing transcatheter aortic valve implantation (TAVI)
Participants
3,996 patients7 RCTs
Comparison
Cerebral embolic protection (CEP) vs standard treatment during TAVI
  • CEPn = 2,126
  • Controln = 1,870reference
Outcome
Disabling stroke
Methodological detailsvague prior (principal), informed literature-based priors (secondary)
  • Vague prior (principal)
  • Informed literature-based priors (secondary)

Pooled result

As reported in the abstract

Median relative risk

0.56

95% CrI 0.28–1.19

CEPvs Control
median RR 0.56 (95% CrI 0.28–1.19)
Posterior probability of any benefit
94.4%
Probability of clinically relevant effect (MCID 1.1% ARD, NNT 91), vague and informed priors
0-0.1%

Further pooled results

Results robust across multiple sensitivity analyses

Original publication

Stroke reduction by cerebral embolic protection devices in transcatheter aortic valve implantation: a systematic review and Bayesian meta-analysis. Heart. Published 23 November 2023. doi:10.1136/heartjnl-2023-323359

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