Valvular & structural heart disease

Coronary Events After Transcatheter Aortic Valve Replacement: Insights From the France TAVI Registry

JACC Cardiovasc IntervPublished 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

OutcomeOR (95% CI)P value
Likelihood of PCI after CE when admitted to a TAVR center — TAVR center vs BEV · all patients1.20 (1.01–1.42)P = 0.04
Likelihood of PCI after CE when admitted to a TAVR center — TAVR center vs BEV · BEV patients1.42 (1.18–1.71)P = 0.002
  • 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: Insights From the France TAVI Registry. 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

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