Valvular & structural heart diseaseSecondary analysis
Impact of Coronary Diameter Stenosis and Proximal Lesion Location on Outcomes Following Percutaneous Coronary Intervention (PCI) in Patients Undergoing TAVI: Prespecified NOTION-3 Substudy
- prespecified subanalysis of the NOTION-3 trial
- randomized
Authors' conclusion
The beneficial effect of PCI in patients undergoing transcatheter aortic valve implantation with physiologically significant stable coronary artery disease was seemingly pronounced in patients with high-grade stenosis, while stenosis location was not found to modify the outcome despite an almost similar beneficial effect with PCI in patients with proximal stenosis.
Study context
- Population
- Patients with severe symptomatic aortic stenosis and physiologically significant stable coronary artery disease undergoing transcatheter aortic valve implantationdiameter stenosis <90% 184 · diameter stenosis ≥90% 271 · at least 1 proximal stenosis 294 · nonproximal stenoses 161
- Participants
- 455 randomized patients
- Comparison
- PCI or conservative treatment of coronary artery disease with transcatheter aortic valve implantation, stratified by diameter stenosis (<90% or ≥90%) and stenosis location (proximal or nonproximal)
- Primary endpoint
- Major adverse cardiovascular event (all-cause death, myocardial infarction, and urgent revascularization), by diameter stenosis
- Follow-up
- Median 2 years (interquartile range, 1-4)
Primary result
As reported in the abstract
PCI vs conservative treatmentHazard ratio (95% CI)
diameter stenosis ≥90%: PCI 24% versus conservative treatment 37%; absolute risk reduced by 13%
0.53(0.34–0.82)
diameter stenosis <90%: 31% versus 33%
1.04(0.62–1.73)
Further findings
| Outcome | PCI | conservative treatment | hazard ratio (95% CI) | |
|---|---|---|---|---|
| Major adverse cardiovascular event, by stenosis location · proximal stenosis | 26% | 38% | 0.61 (0.40–0.93) | |
| Major adverse cardiovascular event, by stenosis location · nonproximal stenosis | 28% | 32% | 0.91 (0.52–1.61) | |
| 0.512Hazard ratio (log scale) |
- Major adverse cardiovascular event, by stenosis location: P for interaction=0.27
Original publication
Impact of Coronary Diameter Stenosis and Proximal Lesion Location on Outcomes Following PCI in Patients Undergoing TAVI: Prespecified NOTION-3 Substudy. Circ Cardiovasc Interv. Published 24 July 2026. doi:10.1161/circinterventions.125.016286
Summarised from the published abstract; every number is checked against it