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 -