Author + information
- Hambik Tankazyan,
- Gaurav Tyagi,
- Amanda Stebbins,
- Roland Matsouaka,
- Alice Wang,
- Sreekanth Vemulapalli,
- Kenneth Jutzy,
- Islam Abudayyeh,
- Wilson Szeto,
- David Cohen,
- Vinod Thourani and
- Anthony Hilliard
Background: In patients with severe aortic stenosis being evaluated for transcatheter aortic valve replacement (TAVR), co-existence of significant coronary artery disease (CAD) is fairly prevalent and portends a poorer prognosis in long-term outcomes. There is no consensus at this time regarding appropriate management and timing of revascularization in this population of patients.
Methods: Using 47783 patients from the TVT registry, we compared baseline characteristics and clinical outcomes at 30 days and at 1 year in patients with different degrees of CAD severity and those having undergone percutaneous coronary intervention (PCI). An analysis was performed to evaluate the effect of timing of PCI on clinical outcomes, comparing PCI within 1 month of TAVR with PCI between 1 to 3 months prior to TAVR.
Results: There was no association between CAD severity and mortality within 30 days of TAVR. The unadjusted 1-year mortality rates were higher in the severe CAD population (Effect estimate 1.132, 1.048-1.224), however the finding did not persist after adjustment for pre-specified risk factors. There was no difference in 30 day and 1-year mortality rates between the prior PCI and no prior PCI cohorts, after adjustment for risk factors. There was a significantly higher risk of mortality among patients undergoing PCI within 1 month of TAVR compared to PCI between 1 and 3 months prior to TAVR date (T value 5.187, p=0.023).
Conclusions: In our large registry study, we found that the severity of coronary artery disease did not have a significant effect on outcomes at 30 days and 1 year following TAVR. Prior PCI, without taking timing into consideration, did not demonstrate any significant effect on outcomes following TAVR. We did find a significantly higher mortality rate among patients who underwent PCI just one month prior to TAVR, compared to those undergoing PCI 1 to 3 months prior to TAVR.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-189
- 2017 American College of Cardiology Foundation