Valvular & structural heart diseaseCohort study
Coronary Events After Transcatheter Aortic Valve Replacement
- Registry-based cohort study
Authors' conclusion
The yearly incidence of CE after TAVR is low. In the event of CE, patients who have not undergone PCI have a worse outcome. SEV patients have a higher rate of unfavorable outcomes and are less likely to undergo PCI, especially when admitted to non-TAVR centers.
Study context
- Population
- Patients undergoing transcatheter aortic valve replacement (TAVR) for native AS in the France-TAVI registry, 2013–2021Balloon-expandable valves (BEV) 63.8%, self-expandable valves (SEV) 36.2%
- Participants
- 64,660 patients
- Exposure
- BEV vs SEV; Percutaneous coronary intervention (PCI) vs coronary angiography only vs no intervention after coronary events (CE)
- Outcome
- Rate of first hospitalization for coronary events (CE)
- Follow-up
- Maximal
Main finding
As reported in the abstract
First hospitalization for CE
CE occurred
11.6%
Yearly CE incidence
1.5%/y
Observational data: associations, not effects.
Secondary outcomes
All-cause mortality or HF hospitalisation after CE, by valve type
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Likelihood of PCI after CE when admitted to a TAVR center — TAVR center vs BEV · all patients | 1.20 (1.01–1.42) | P = 0.04 | |
| Likelihood of PCI after CE when admitted to a TAVR center — TAVR center vs BEV · BEV patients | 1.42 (1.18–1.71) | P = 0.002 | |
| 0.512Odds ratio (log scale) |
- All-cause mortality or HF hospitalisation after CE, by management (main secondary endpoint): PCI 79.6%
- All-cause mortality or HF hospitalisation after CE, by management (main secondary endpoint): Coronary angiography only 85.2%
- All-cause mortality or HF hospitalisation after CE, by management (main secondary endpoint): No intervention 86.5%
- All-cause mortality or HF hospitalisation after CE, by management (main secondary endpoint): P = 0.002
- All-cause mortality or HF hospitalisation after CE, by valve type: P = 0.01
Original publication
Coronary Events After Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv. Published 27 January 2025. doi:10.1016/j.jcin.2024.09.005
Summarised from the published abstract; every number is checked against it