Percutaneous Coronary Intervention Is Safe Prior Transcatheter Aortic Valve Replacement

Elyasi, Maekal; Rambhujun, Vikashsingh; Medranda, Giorgio A.; Sapia, Paul; Islam, Shahidul; Green, Stephen

doi:10.1016/s0735-1097(18)31869-2

Cited by 1 publication

(2 citation statements)

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“…The systematic search yielded 1640 studies. A total of 14 studies-13 observational studies and 1 randomised controlled trial (RCT)-were included in this meta-analysis (see Figure S1 in Electronic Supplementary Material), with a total of 3838 patients [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Importantly, different definitions for significant CAD were used, with cut-off values for significant lesions ranging from 50% to 75% obstruction in a major coronary artery.…”

Section: Systematic Searchmentioning

confidence: 99%

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Percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis

Aarts,

van Hemert,

Meijs

et al. 2023

Neth Heart J

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Objective The importance of revascularisation of significant coronary artery disease (CAD) in patients undergoing transcatheter aortic valve implantation (TAVI) is unclear. Despite the lack of randomised controlled trials comparing different revascularisation strategies, guidelines currently recommend percutaneous coronary intervention (PCI) in patients with significant proximal CAD undergoing TAVI. Methods In this systematic review and meta-analysis, a systematic search was conducted to identify studies comparing TAVI with and without PCI in patients with significant CAD on pre-TAVI coronary angiography. Endpoints were all-cause mortality, cardiac death, stroke, myocardial infarction and major bleeding. Results In total, 14 studies were included, involving 3838 patients, of whom 1806 (47%) underwent PCI before TAVI. All-cause mortality did not differ significantly between TAVI with and without preceding PCI at 30 days, 1 year and > 1 year. There were no significant differences in risk of cardiac death, stroke or myocardial infarction between the groups. However, TAVI performed with PCI resulted in a higher risk of major bleeding within 30 days after TAVI (odds ratio: 0.66; 95% confidence interval: 0.46–0.94). Conclusion This systematic review and meta-analysis showed no significant differences in clinical outcomes between patients with concomitant significant CAD who were treated with TAVI with and without preceding PCI at both short- and long-term follow-up. However, there was a higher risk of major bleeding at 30 days in patients undergoing TAVI with preceding PCI. In the context of serious risk of bias in the included studies, results of randomised controlled trials are warranted.

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Section: Systematic Searchmentioning

confidence: 99%

“…1a; [8, 9, 11-14, 16-19, 21]) and 1 year (13.6% vs 16.4%; OR: 0.91; 95% CI: 0.64-1.29; p = 0.59; I 2 : 45%) (Fig. 2a; [10,11,13,14,16,18,20,21]). Two studies reported on all-cause mortality > 1 year, but no significant difference was found between patients with TAVI only and those with TAVI and PCI 3a; [15,20]).…”

Section: All-cause Mortalitymentioning

confidence: 99%