Impact of coronary artery disease in patients undergoing transcatheter aortic valve replacement: Insights from the FRANCE-2 registry

Puymirat, Étienne; Didier, Romain; Eltchaninoff, Hélène; Lung, Bernard; Collet, Jean-Phillipe; Himbert, Dominique; Durand, Éric; Leguerrier, Alain; Leprince, Pascal; Teíger, Emmanuel; Michel, Lars; Tchétché, Didier; Leclerc, Francis; Chassaing, S.; Lebreton, H.; Donzeau–Gouge, Patrick; Lefevre, T.; Carrié, Didier; Blanchard, D.

doi:10.1016/j.acvdsp.2017.11.051

Cited by 5 publications

(6 citation statements)

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“…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 . Conversely, numerous studies did not demonstrate a significant impact of CAD on outcomes after TAVR . A possible explanation of this discrepancy may reside in the extent and complexity of CAD across trials .…”

Section: Discussionmentioning

confidence: 71%

“…9,10 Conversely, numerous studies did not demonstrate a significant impact of CAD on outcomes after TAVR. [18][19][20][21][22][23][24] A possible explanation of this discrepancy may reside in the extent and complexity of CAD across trials. 4 Indeed, composite definitions of CAD have been used in the literature with various combinations of prior MI, coronary revascularization (by PCI or coronary artery bypass graft surgery) or angiographic severity of coronary atherosclerosis.…”

Section: Impact Of Cad With and Without Recent Pcimentioning

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: Discussionmentioning

confidence: 71%

Section: Impact Of Cad With and Without Recent Pcimentioning

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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“…Lack of data on the degree of CAD and its physiological burden were the main limitations of this study. Although Dewey et al showed that CAD is an independent predictor of early and midterm survival, this finding was not supported by other studies [12][13][14][15][16]. A meta-analysis of adjusted observational results from seven studies and 2472 patients concluded that CAD does not affect TAVR outcomes after a median follow-up of 452 days.…”

Section: Coronary Artery Disease In Patients Undergoing Tavrmentioning

confidence: 91%

Timing and Outcomes of PCI in the TAVR Era

Voudris

Petropulos

Karyofillis

et al. 2018

Curr Treat Options Cardio Med

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Percutaneous coronary intervention (PCI) in patients with CAD and severe AS has been shown to be feasible and safe. Whether revascularization before, during, or after TAVR is optimal remains a subject of debate. All three approaches represent valid strategies with advantages and disadvantages that need to be carefully weighed on an individual basis. Current expert opinions recommend that PCI should be performed before or at the time of TAVR as long as the risk of the procedure does not outweigh the potential benefits. The results of large clinical trials evaluating the optimal revascularization time are closely awaited.

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“…French TAVI registry, showed extent of CAD not to affect three-year survival; with significant left anterior descending (LAD) lesion alone increasing mortality. 47 However, 8013 patient meta-analysis showed CAD increased one-year mortality. 48 Another, two meta-analyses (n > 11,000), showed Syntax score >22 increased one-year mortality, 44 and high residual Syntax score following percutaneous coronary intervention (PCI) pre-TAVI, correlated with one-to three-year mortality.…”

Section: Coronary Artery Disease and Tavimentioning

confidence: 99%

Transcatheter aortic valve implantation in low-risk patients: A case of rational over exuberance. The time is not now

Navaratnarajah

Luthra

Ohri

2021

Asian Cardiovasc Thorac Ann

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Background Review of evidence and concerns, relating to extension of transcatheter aortic valve implantation usage to low–risk patients. Methods Comprehensive literature review was conducted identifying articles relating to transcatheter aortic valve implantation. Results Transcatheter aortic valve implantation is effective in patients with aortic stenosis. Currently, long-term durability and cost-effectiveness are unproven, anticoagulation requirement undefined, permanent pacemaker implantation and paravalvular leak rates higher than following surgical aortic valve replacement. Conclusions Current evidence supporting transcatheter aortic valve implantation usage in low-risk patients is insufficient. Extending use now, to this large young patient population is premature, and should be delayed.

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Impact of coronary artery disease in patients undergoing transcatheter aortic valve replacement: Insights from the FRANCE-2 registry

Cited by 5 publications

References 0 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

Timing and Outcomes of PCI in the TAVR Era

Transcatheter aortic valve implantation in low-risk patients: A case of rational over exuberance. The time is not now

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