New data reveals that percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) can be safely performed before, during, and after transcatheter aortic valve replacement (TAVR). The results of the analysis were presented today at the 2024 Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI).
For patients with CAD, PCI and TAVR are often required to restore blood flow. Many clinicians prefer to perform PCI before TAVR due to complications that may occur during the replacement procedure. However, the optimal timing of PCI for patients undergoing TAVR remains controversial.
The analysis included 49,344 patients with stable CAD who underwent PCI before (84.7%), after (1.3%), or concurrently (14%) with TAVR using the Sapien 3 (S3) platform balloon-expandable bioprosthesis. was included. This analysis was conducted using the TVT Registry and Medicare linkage from 2015 to 2024.
In propensity-matched analysis, the combined all-cause mortality and stroke rates were similar in the three groups over 3 years of follow-up. The authors concluded that due to the small number of patients undergoing PCI after TAVR, when comparing only the other two groups (pre-PCI and combined PCI), PCI performed before TAVR was significantly less likely to be associated with TAVR at 3 years. It was noted that it was slightly advantageous over combined PCI (P =0.012).
These findings are interesting because they differ slightly from previously published registry data. We believe this data provides confidence and supporting evidence for many physicians and cardiac teams to make decisions regarding the timing of PCI in patients undergoing TAVR. ”
Abhijeet Dhoble, MD, MPH, FACC, FSCAI, cardiologist at the University of Texas Health Science Center at Houston and lead author of the study
Session details:
- “Timing of percutaneous coronary intervention in conjunction with transcatheter aortic valve replacement with balloon-expandable valves in the United States.”
- Friday, May 3, 2024. 3:14pm – 3:21pm Pacific Time
- Long Beach Convention Center, 104A, 1st floor
sauce:
Society of Cardiovascular Angiography and Interventions