Cohort study
Impact of untreated chronic obstructive coronary artery disease on outcomes after transcatheter aortic valve replacement
- Retrospective cohort study
Authors' conclusion
Transcatheter aortic valve replacement can be performed safely in patients with untreated chronic obstructive CAD, without portending higher procedural complication rates and with relatively low rates of unplanned coronary revascularization and acute coronary syndrome at 1 year.
Study context
- Population
- Transcatheter aortic valve replacement (TAVR) recipients, January 2015 to November 2021
- Participants
- 1,911 recipients
- Exposure
- Untreated obstructive coronary artery disease (CAD) of varying severity vs non-obstructive CAD in TAVR recipients
- Outcome
- Procedural all-cause mortality and complications, MACE, and post-TAVR unplanned coronary revascularization
Main finding
As reported in the abstract
Procedural complications (overall)
Procedural death
0.4%
Procedural shock
0.1%
Procedural ECMO
0.1%
Observational data: associations, not effects.
Further findings
| Outcome | Non-obstructive | Intermediate-risk | High-risk | Extreme-risk | P value |
|---|---|---|---|---|---|
| ACS and unplanned coronary revascularization · median follow-up 21 months | |||||
| ACS | 0.7% | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | |
| Unplanned coronary revascularization | 0.5% | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | |
| ACS and unplanned coronary revascularization rates, time-to-event analyses · 1 year | 98% | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | Plog-rank< .001 |
- ACS and unplanned coronary revascularization — Incidence rising with increasing severity of CAD
- P < .001
- ACS and unplanned coronary revascularization rates, time-to-event analyses: Obstructive 94%
Original publication
Impact of untreated chronic obstructive coronary artery disease on outcomes after transcatheter aortic valve replacement. Eur Heart J. Published 25 January 2024. doi:10.1093/eurheartj/ehae019
Summarised from the published abstract; every number is checked against it