Clinical outcomes of percutaneous coronary interventions after transcatheter aortic valve replacement
Year: 2025
Type: article
Study design: Observational Study
Abstract: Aims The number of patients undergoing percutaneous coronary interventions (PCI) after transcatheter aortic valve replacement (TAVR) is expected to increase, but their prognosis remains poorly understood. Methods and results Consecutive PCI patients with prior TAVR were compared to patients without prior TAVR between 2008 and 2023. The Kaplan–Meier method was used to estimate the 1-year incidence of major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death or myocardial infarction. An entropy balance approach was implemented to adjust for imbalances in patient and procedural characteristics. Adjusted hazard ratios (HRs) were estimated using weighted Cox regression models. Comparing 420 PCI patients with prior TAVR (mean age 80.8 years, 37.1% women) to 1197 without (mean age 70.4 years, 24.6% women), 1-year MACE was higher in the prior TAVR group (8.7 vs. 3.7%; unadjusted HR 2.35, 95% CI 1.49–3.69; P < 0.001). After adjustment for clinical and procedural characteristics, prior TAVR remained associated with an increased risk of MACE (adjusted HR 2.36, 95% CI 1.08–5.16; P = 0.032). This was primarily driven by higher cardiovascular death (adjusted HR 3.12, 95% CI 1.10–8.79, P = 0.032), while the association with myocardial infarction was attenuated post-adjustment and no longer statistically significant. Conclusion Patients undergoing PCI after TAVR experience a higher incidence of MACE compared to those undergoing PCI without prior TAVR, underscoring the importance of accurate patient selection before performing PCI in patients with chronic coronary syndrome and history of TAVR.
Source: European Heart Journal Open
Authors: Carlo A Pivato, Ottavia Cozzi, Nicole Fontana, Francesca Ieva, Gianluigi Condorelli, Cosmo Godino, Bernhard Reimers, Masaaki Nakase, Karsten Hug, Tobias Rheude, Antonio J Munoz-Garcia, Victor Alfonso Jimenez Diaz, Alfonso Ielasi, Marco Barbanti, Luigi Biasco, Darren Mylotte, Massimo Leoncini, Jose M de la Torre Hernandez, Giorgio Quadri, Ferdinando Varbella, Angelo Anzuini, Diego Lopez, Philippe Garot, Jorn Brouwer, Antonio Mangieri, Damiano Regazzoli, Luca Testa, Jorge Sanz Sanchez, Daijiro Tomii, Alaide Chieffo, Michael Joner, Gennaro Sardella, Enrico Cerrato, Luis Nombela-Franco, Thomas Pilgrim, Giulio Stefanini
Institutions: Humanitas University, IRCCS Humanitas Research Hospital, Human Technopole, Politecnico di Milano, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, University of Bern, University Hospital of Bern, Deutsches Herzzentrum München, Technical University of Munich, Hospital Clínico Universitario Virgen de la Victoria, University Hospital Complex Of Vigo, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Università degli Studi di Enna Kore, Università della Svizzera italiana, Ollscoil na Gaillimhe – University of Galway, University Hospital Galway, Ospedale di Sanremo, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, A. O. Ordine Mauriziano di Torino, Ospedale San Luigi Gonzaga, Humanitas Mater Domini, Complejo Hospitalario de Pontevedra, Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, St. Antonius Ziekenhuis, IRCCS Policlinico San Donato, Hospital Universitari i Politècnic La Fe, Centro de Investigación Biomédica en Red, Policlinico Umberto I, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,673
OpenAlex ID: W4414368653