Abstract
Aims: We sought to compare different PCI timing strategies in TAVI patients.
Methods: The REVASC-TAVI registry is an international registry including patients undergoing TAVI with significant, stable coronary artery disease (CAD) at preprocedural workup. In this analysis, patients scheduled to undergo PCI before, after or concomitantly with TAVI were included. The main endpoints were all-cause death and a composite of all-cause death, stroke, myocardial infarction (MI) or rehospitalisation for congestive heart failure (CHF) at 2 years. Outcomes were adjusted using the inverse probability treatment weighting (IPTW) method.
Results: A total of 1,603 patients were included. PCI was performed before, after or concomitantly with TAVI in 65.6% (n=1,052), 9.8% (n=157) or 24.6% (n=394), respectively. At 2 years, all-cause death was significantly lower in patients undergoing PCI after TAVI as compared with PCI before or concomitantly with TAVI (6.8% vs 20.1% vs 20.6%; p<0.001). Likewise, the composite endpoint was significantly lower in patients undergoing PCI after TAVI as compared with PCI before or concomitantly with TAVI.
Originalsprog | Engelsk |
---|---|
Tidsskrift | EuroIntervention |
Vol/bind | 19 |
Udgave nummer | 7 |
Sider (fra-til) | 589-599 |
Antal sider | 11 |
ISSN | 1774-024X |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Publisher Copyright:© Europa Digital & Publishing 2023. All rights reserved.
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Comparison of different percutaneous revascularisation timing strategies in patients undergoing transcatheter aortic valve implantation. / Rheude, Tobias; Costa, Giuliano; Ribichini, Flavio Luciano; Pilgrim, Thomas; Amat-Santos, Ignacio J.; De Backer, Ole; Kim, Won Keun; Ribeiro, Henrique Barbosa; Saia, Francesco; Bunc, Matjaz; Tchétché, Didier; Garot, Philippe; Mylotte, Darren; Burzotta, Francesco; Watanabe, Yusuke; Bedogni, Francesco; Tesorio, Tullio; Tocci, Marco; Franzone, Anna; Valvo, Roberto; Savontaus, Mikko; Wienemann, Hendrik; Porto, Italo; Gandolfo, Caterina; Iadanza, Alessandro; Bortone, Alessandro S.; Mach, Markus; Latib, Azeem; Biasco, Luigi; Taramasso, Maurizio; Zimarino, Marco; Tomii, Daijiro; Nuyens, Philippe; Sondergaard, Lars; Camara, Sergio F.; Palmerini, Tullio; Orzalkiewicz, Mateusz; Steblovnik, Klemen; Degrelle, Bastien; Gautier, Alexandre; Del Sole, Paolo Alberto; Mainardi, Andrea; Pighi, Michele; Lunardi, Mattia; Kawashima, Hideyuki; Criscione, Enrico; Cesario, Vincenzo; Biancari, Fausto; Zanin, Federico; Esposito, Giovanni; Adam, Matti; Grube, Eberhard; Baldus, Stephan; De Marzo, Vincenzo; Piredda, Elisa; Cannata, Stefano; Iacovelli, Fortunato; Andreas, Martin; Frittitta, Valentina; Dipietro, Elena; Reddavid, Claudia; Strazzieri, Orazio; Motta, Silvia; Angellotti, Domenico; Sgroi, Carmelo; Xhepa, Erion; Kargoli, Faraj; Tamburino, Corrado; Joner, Michael; Barbanti, Marco.
I: EuroIntervention, Bind 19, Nr. 7, 2023, s. 589-599.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
}
TY - JOUR
T1 - Comparison of different percutaneous revascularisation timing strategies in patients undergoing transcatheter aortic valve implantation
AU - Rheude, Tobias
AU - Costa, Giuliano
AU - Ribichini, Flavio Luciano
AU - Pilgrim, Thomas
AU - Amat-Santos, Ignacio J.
AU - De Backer, Ole
AU - Kim, Won Keun
AU - Ribeiro, Henrique Barbosa
AU - Saia, Francesco
AU - Bunc, Matjaz
AU - Tchétché, Didier
AU - Garot, Philippe
AU - Mylotte, Darren
AU - Burzotta, Francesco
AU - Watanabe, Yusuke
AU - Bedogni, Francesco
AU - Tesorio, Tullio
AU - Tocci, Marco
AU - Franzone, Anna
AU - Valvo, Roberto
AU - Savontaus, Mikko
AU - Wienemann, Hendrik
AU - Porto, Italo
AU - Gandolfo, Caterina
AU - Iadanza, Alessandro
AU - Bortone, Alessandro S.
AU - Mach, Markus
AU - Latib, Azeem
AU - Biasco, Luigi
AU - Taramasso, Maurizio
AU - Zimarino, Marco
AU - Tomii, Daijiro
AU - Nuyens, Philippe
AU - Sondergaard, Lars
AU - Camara, Sergio F.
AU - Palmerini, Tullio
AU - Orzalkiewicz, Mateusz
AU - Steblovnik, Klemen
AU - Degrelle, Bastien
AU - Gautier, Alexandre
AU - Del Sole, Paolo Alberto
AU - Mainardi, Andrea
AU - Pighi, Michele
AU - Lunardi, Mattia
AU - Kawashima, Hideyuki
AU - Criscione, Enrico
AU - Cesario, Vincenzo
AU - Biancari, Fausto
AU - Zanin, Federico
AU - Esposito, Giovanni
AU - Adam, Matti
AU - Grube, Eberhard
AU - Baldus, Stephan
AU - De Marzo, Vincenzo
AU - Piredda, Elisa
AU - Cannata, Stefano
AU - Iacovelli, Fortunato
AU - Andreas, Martin
AU - Frittitta, Valentina
AU - Dipietro, Elena
AU - Reddavid, Claudia
AU - Strazzieri, Orazio
AU - Motta, Silvia
AU - Angellotti, Domenico
AU - Sgroi, Carmelo
AU - Xhepa, Erion
AU - Kargoli, Faraj
AU - Tamburino, Corrado
AU - Joner, Michael
AU - Barbanti, Marco
N1 - Publisher Copyright: © Europa Digital & Publishing 2023. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background: The optimal timing to perform percutaneous coronary interventions (PCI) in transcatheter aortic valve implantation (TAVI) patients remains unknown. Aims: We sought to compare different PCI timing strategies in TAVI patients. Methods: The REVASC-TAVI registry is an international registry including patients undergoing TAVI with significant, stable coronary artery disease (CAD) at preprocedural workup. In this analysis, patients scheduled to undergo PCI before, after or concomitantly with TAVI were included. The main endpoints were all-cause death and a composite of all-cause death, stroke, myocardial infarction (MI) or rehospitalisation for congestive heart failure (CHF) at 2 years. Outcomes were adjusted using the inverse probability treatment weighting (IPTW) method. Results: A total of 1,603 patients were included. PCI was performed before, after or concomitantly with TAVI in 65.6% (n=1,052), 9.8% (n=157) or 24.6% (n=394), respectively. At 2 years, all-cause death was significantly lower in patients undergoing PCI after TAVI as compared with PCI before or concomitantly with TAVI (6.8% vs 20.1% vs 20.6%; p<0.001). Likewise, the composite endpoint was significantly lower in patients undergoing PCI after TAVI as compared with PCI before or concomitantly with TAVI (17.4% vs 30.4% vs 30.0%; p=0.003). Results were confirmed at landmark analyses considering events from 0 to 30 days and from 31 to 720 days. Conclusions: In patients with severe aortic stenosis and stable coronary artery disease scheduled for TAVI, performance of PCI after TAVI seems to be associated with improved 2-year clinical outcomes compared with other revascularisation timing strategies. These results need to be confirmed in randomised clinical trials.
AB - Background: The optimal timing to perform percutaneous coronary interventions (PCI) in transcatheter aortic valve implantation (TAVI) patients remains unknown. Aims: We sought to compare different PCI timing strategies in TAVI patients. Methods: The REVASC-TAVI registry is an international registry including patients undergoing TAVI with significant, stable coronary artery disease (CAD) at preprocedural workup. In this analysis, patients scheduled to undergo PCI before, after or concomitantly with TAVI were included. The main endpoints were all-cause death and a composite of all-cause death, stroke, myocardial infarction (MI) or rehospitalisation for congestive heart failure (CHF) at 2 years. Outcomes were adjusted using the inverse probability treatment weighting (IPTW) method. Results: A total of 1,603 patients were included. PCI was performed before, after or concomitantly with TAVI in 65.6% (n=1,052), 9.8% (n=157) or 24.6% (n=394), respectively. At 2 years, all-cause death was significantly lower in patients undergoing PCI after TAVI as compared with PCI before or concomitantly with TAVI (6.8% vs 20.1% vs 20.6%; p<0.001). Likewise, the composite endpoint was significantly lower in patients undergoing PCI after TAVI as compared with PCI before or concomitantly with TAVI (17.4% vs 30.4% vs 30.0%; p=0.003). Results were confirmed at landmark analyses considering events from 0 to 30 days and from 31 to 720 days. Conclusions: In patients with severe aortic stenosis and stable coronary artery disease scheduled for TAVI, performance of PCI after TAVI seems to be associated with improved 2-year clinical outcomes compared with other revascularisation timing strategies. These results need to be confirmed in randomised clinical trials.
KW - • TAVI
KW - •aortic stenosis
KW - •coronary artery disease
U2 - 10.4244/EIJ-D-23-00186
DO - 10.4244/EIJ-D-23-00186
M3 - Journal article
C2 - 37436190
AN - SCOPUS:85169139358
VL - 19
SP - 589
EP - 599
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 7
ER -