Effects of coronary artery disease in patients undergoing transcatheter aortic valve implantation: A study of age- and gender-matched cohorts

Franzone, Anna; Stortecky, Stefan; Räber, Lorenz; Heg, Dik; Yamaji, Kyohei; Piccolo, Raffaele; Asami, Masahiko; Lanz, Jonas; Praz, Fabien; Koskinas, K; Zanchin, Thomas; Wenaweser, Peter; Valgimigli, Marco; Jüni, Peter; Pilgrim, Thomas; Windecker, Stephan

doi:10.1016/j.ijcard.2017.05.071

Cited by 25 publications

(21 citation statements)

References 29 publications

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“…The results of the current study are aligned with recent studies describing a similar adverse effect of CAD on early and long-term outcomes after TAVR. 5,12,16,17 The present study brings further insights by demonstrating this impact in a women-only population, who despite posing for half of the population undergoing TAVR, have not been extensively evaluated in this context. 9,10 Conversely, numerous studies did not demonstrate a significant impact of CAD on outcomes after TAVR.…”

Section: Impact Of Cad With and Without Recent Pcimentioning

confidence: 90%

“…2,3 Despite this high prevalence, the impact of CAD and its management with percutaneous coronary intervention (PCI) on outcomes remains debated, with contrasting results from observational studies. [4][5][6][7] Women, who display a specific risk-profile for both PCI 8,9 and TAVR, 9,10 have not been specifically studied in this setting. The Women's International Transcatheter Aortic Valve implantation (WIN-TAVI) registry was design to investigate the performance of contemporary TAVR and determinants of adverse outcome among women.…”

Section: Introductionmentioning

confidence: 99%

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Impact of coronary artery disease and percutaneous coronary intervention in women undergoing transcatheter aortic valve replacement: From the WIN‐TAVI registry

Guedeney

Tchétché

Petronio

et al. 2018

Cathet Cardio Intervent

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Objectives: To evaluate the impact of coronary artery disease (CAD) with or without recent (≤ 30 days) percutaneous coronary intervention (PCI) in women undergoing transcatheter aortic valve replacement (TAVR).Background: Although women display a specific risk-profile for both PCI and TAVR, the impact of CAD and PCI in the setting of TAVR in women is unclear. Methods:The multinational Women's International Transcatheter Aortic Valve implantation registry enrolled consecutive female patients undergoing contemporary TAVR in 19 centers between 2013 and 2015. Patients with available coronary angiography or CT scan in the pre-operative assessment of TAVR were categorized as without CAD, with CAD but no recent PCI and CAD and recent PCI (≤30 days). All events were adjudicated according to the VARC-2 criteria.Results: A total of 787 patients were included in this analysis, among whom 459 (58.3%) had no CAD, 247 (31.4%) had CAD without recent PCI and 81 (10.3%) underwent recent PCI (≤ 30 days before TAVR). After multivariable adjustment, both groups of CAD patients, without and with recent PCI, presented with higher risk of death, myocardial infarction or stroke, compared with patients without CAD ( adj HR 1.56, 95%CI 1.03-2.39, P = 0.038 and adj HR 1.96, 95% CI 1.1-3.5, P = .021, respectively). Patients with recent PCI had increased risk of all-cause death ( adj HR 1.89, 95% CI 1.0-3.5, P = 0.04) and stroke ( adj HR 3.7, 95% CI 1.0-13.5, P = 0.046) compared with patients without CAD. Conclusion:The presence of CAD in women undergoing TAVR, with or without recent PCI, was associated with long-term poorer outcomes. K E Y W O R D Saortic stenosis, gender issue, transcatheter aortic valve replacement

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Section: Impact Of Cad With and Without Recent Pcimentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Impact of coronary artery disease and percutaneous coronary intervention in women undergoing transcatheter aortic valve replacement: From the WIN‐TAVI registry

Guedeney

Tchétché

Petronio

et al. 2018

Cathet Cardio Intervent

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“…A significantly increased rate of major adverse cardiovascular and cerebrovascular events (MACCE) at 1 year was observed in patients undergoing TAVI with concomitant Structural frequently with diabetes mellitus, peripheral artery disease, chronic renal failure and a greater extent and complexity of coronary lesions compared with patients with stable CAD without AS. 28 Conversely, results from the UK TAVI registry outlined that CAD, albeit associated with greater comorbid conditions, predicted neither shortnor long-term survival. 11 Similarly, in the ADVANCE study, neither CAD, nor history of MI or prior revascularisation were found to be predictors of mortality at 12 months.…”

Section: Why Treat: Impact Of Coronary Artery Disease On Clinical Outmentioning

confidence: 98%

Coronary Revascularisation in Transcatheter Aortic Valve Implantation Candidates: Why, Who, When?

Cao¹,

Chiarito²,

Pagnotta³

et al. 2018

Interventional Cardiology Review

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Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist. The presence of CAD has been consistently associated with an impaired prognosis in patients undergoing surgical aortic valve replacement during short- and long-term follow-up. Accordingly, current guidelines recommend coronary revascularisation of all significant stenoses in patients undergoing surgical aortic valve replacement. Conversely, the management of concomitant CAD in patients with severe AS undergoing transcatheter aortic valve implantation (TAVI) is still a matter of debate. The aim of this review article is to provide an overview on the role of coronary revascularisation in TAVI patients.

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“…Interestingly, the risk of ischemic events during 1-year follow-up among TAVR patients without CAD was similar compared to that of a matched population of CAD patients undergoing PCI during 1-year follow-up (2). Along the same line, in a TAVR registry from the United Kingdom, the presence of CAD was significantly associated with increased mortality at 2 years of follow-up (3).…”

Section: Clinical Implications Of Obstructive Cad In Tavr Candidatesmentioning

confidence: 82%

Coronary artery disease and myocardial revascularization in patients undergoing transcatheter aortic valve replacement

2017

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Effects of coronary artery disease in patients undergoing transcatheter aortic valve implantation: A study of age- and gender-matched cohorts

Abstract: Concomitant CAD in the setting of TAVI conveyed an increased risk of ischemic events and cardiovascular mortality at 1-year follow-up.

Cited by 25 publications

References 29 publications

Impact of coronary artery disease and percutaneous coronary intervention in women undergoing transcatheter aortic valve replacement: From the WIN‐TAVI registry

Impact of coronary artery disease and percutaneous coronary intervention in women undergoing transcatheter aortic valve replacement: From the WIN‐TAVI registry

Coronary Revascularisation in Transcatheter Aortic Valve Implantation Candidates: Why, Who, When?

Coronary artery disease and myocardial revascularization in patients undergoing transcatheter aortic valve replacement

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