Clinical research

DOI: 10.4244/EIJ-D-23-00186

Comparison of different percutaneous revascularisation timing strategies in patients undergoing transcatheter aortic valve implantation

Tobias Rheude1, MD; Giuliano Costa2, MD; Flavio Luciano Ribichini3, MD; Thomas Pilgrim4, MD; Ignacio J. Amat Santos5, MD; Ole De Backer6, MD; Won‐Keun Kim7, MD; Henrique Barbosa Ribeiro8, MD; Francesco Saia9, MD; Matjaz Bunc10, MD; Didier Tchétché11, MD; Philippe Garot12, MD; Darren Mylotte13, MD; Francesco Burzotta14, MD; Yusuke Watanabe15, MD; Francesco Bedogni16, MD; Tullio Tesorio16, MD; Marco Tocci17, MD; Anna Franzone18, MD; Roberto Valvo19, MD; Mikko Savontaus20, MD; Hendrik Wienemann21, MD; Italo Porto22, MD; Caterina Gandolfo23, MD; Alessandro Iadanza24, MD; Alessandro S. Bortone25, MD, PhD; Markus Mach26, MD; Azeem Latib27, MD; Luigi Biasco28, MD; Maurizio Taramasso29, MD; Marco Zimarino30, MD; Daijiro Tomii4, MD; Philippe Nuyens6, MD; Lars Sondergaard31, MD, PhD; Sergio F. Camara8, MD; Tullio Palmerini9, MD; Mateusz Orzalkiewicz9, MD; Klemen Steblovnik10, MD; Bastien Degrelle11, MD; Alexandre Gautier12, MD; Paolo Alberto Del Sole3, MD; Andrea Mainardi3, MD; Michele Pighi3, MD; Mattia Lunardi3,13, MD, MSc; Hideyuki Kawashima15, MD; Enrico Criscione16, MD; Vincenzo Cesario32, MD; Fausto Biancari33, MD; Federico Zanin33, MD; Giovanni Esposito18, MD; Matti Adam21, MD; Eberhard Grube21, MD, PhD; Stephan Baldus21, MD; Vincenzo De Marzo22, MD; Elisa Piredda22, MD; Stefano Cannata23, MD; Fortunato Iacovelli25, MD, PhD; Martin Andreas26, MD, PhD; Valentina Frittitta19, MD; Elena Dipietro19, MD; Claudia Reddavid19, MD; Orazio Strazzieri19, MD; Silvia Motta19, MD; Domenico Angellotti18, MD; Carmelo Sgroi2, MD; Erion Xhepa1, MD; Faraj Kargoli27, MD; Corrado Tamburino2, MD, PhD; Michael Joner1, MD; Marco Barbanti2,34, MD

Abstract

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...

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Volume 19 Number 7
Sep 18, 2023
Volume 19 Number 7
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