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Medium-term systemic blood pressure after stenting of aortic coarctation: a systematic review and meta-analysis.
Meijs, Timion A; Warmerdam, Evangeline G; Slieker, Martijn G; Krings, Gregor J; Molenschot, Mirella M C; Meijboom, Folkert J; Sieswerda, Gertjan T; Doevendans, Pieter A; Bouma, Berto J; de Winter, Robbert J; Mulder, Barbara J M; Voskuil, Michiel.
Afiliação
  • Meijs TA; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Warmerdam EG; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Slieker MG; Department of Pediatric Cardiology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
  • Krings GJ; Department of Pediatric Cardiology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
  • Molenschot MMC; Department of Pediatric Cardiology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
  • Meijboom FJ; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Sieswerda GT; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Doevendans PA; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Bouma BJ; Netherlands Heart Institute, Utrecht, The Netherlands.
  • de Winter RJ; Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
  • Mulder BJM; Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
  • Voskuil M; Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
Heart ; 105(19): 1464-1470, 2019 10.
Article em En | MEDLINE | ID: mdl-31315937
OBJECTIVE: Long-term prognosis of patients with coarctation of the aorta (CoA) is impaired due to the high prevalence of hypertension and consequent cardiovascular complications. Although stent implantation results in acute anatomical and haemodynamic benefit, limited evidence exists regarding the late clinical outcome. In this meta-analysis, we aimed to evaluate the medium-term effect of stent placement for CoA on systemic blood pressure (BP). METHODS: PubMed, EMBASE and Cochrane databases were searched for non-randomised cohort studies addressing systemic BP ≥12 months following CoA stenting. Meta-analysis was performed on the change in BP from baseline to last follow-up using a random-effects model. Subgroup analyses and meta-regression were conducted to identify sources of heterogeneity between studies. RESULTS: Twenty-six studies with a total of 1157 patients and a median follow-up of 26 months were included for final analysis. Meta-analysis showed a 20.3 mm Hg (95% CI 16.4 to 24.1 mm Hg; p<0.00001) reduction in systolic BP and an 8.2 mm Hg (12 studies; 95% CI 5.2 to 11.3 mm Hg; p<0.00001) reduction in diastolic BP. A concomitant decrease in the use of antihypertensive medication was observed. High systolic BP and peak systolic gradient at baseline and stenting of native CoA were associated with a greater reduction in systolic BP at follow-up. CONCLUSIONS: Stent implantation for CoA is associated with a significant decline in systolic and diastolic BP during medium-term follow-up. The degree of BP reduction appears to be dependent on baseline systolic BP, baseline peak systolic gradient, and whether stenting is performed for native or recurrent CoA.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Coartação Aórtica / Sístole / Stents / Hipertensão Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Holanda País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Coartação Aórtica / Sístole / Stents / Hipertensão Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Holanda País de publicação: Reino Unido