Effects of coronary artery disease in patients undergoing transcatheter aortic valve implantation: A study of age- and gender-matched cohorts.

Franzone, Anna; Stortecky, Stefan; Räber, Lorenz; Heg, Dik; Yamaji, Kyohei; Piccolo, Raffaele; Asami, Masahiko; Lanz, Jonas; Praz, Fabien; Koskinas, Kostantinos; Zanchin, Thomas; Wenaweser, Peter; Valgimigli, Marco; Jüni, Peter; Pilgrim, Thomas; Windecker, Stephan (2017). Effects of coronary artery disease in patients undergoing transcatheter aortic valve implantation: A study of age- and gender-matched cohorts. International journal of cardiology, 243, pp. 150-155. Elsevier 10.1016/j.ijcard.2017.05.071

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BACKGROUND The prognostic role of concomitant coronary artery disease (CAD) among patients undergoing transcatheter aortic valve implantation (TAVI) is still uncertain. METHODS Data from the Bern TAVI Registry and the Bern PCI Registry were analyzed. Patients with concomitant CAD undergoing TAVI (TAVI+CAD) were age- and gender-matched to the following two cohorts: patients without CAD undergoing TAVI (TAVI-noCAD) and patients with stable CAD undergoing percutaneous coronary intervention (CAD-noAS). Major adverse cardiovascular and cerebrovascular events (MACCE), defined as the composite of cardiovascular death, myocardial infarction, or cerebrovascular events, represented the primary endpoint at 1-year. RESULTS Out of 9478 procedures performed between 2007 and 2013 (807 TAVI; 8671 PCI), three cohorts, each including 248 subjects, were derived. At 1-year, MACCE were significantly increased among TAVI+CAD compared with TAVI-noCAD (16.8% vs. 9.8%, hazard ratio, HR, 1.75, 95% confidence intervals, CI, 1.06-2.89, p=0.030) and CAD-noAS patients (16.8% vs. 9.5%, HR 1.85, 95%CI 1.11-3.09, p=0.018) whereas no difference was found between TAVI-noCAD and CAD-noAS patients. The higher rate of MACCE among TAVI+CAD patients was mainly driven by an increased risk of cardiovascular mortality compared with the TAVI-noCAD (HR 1.86, 95%CI 1.03-3.36, p=0.040) and CAD-noAS cohorts (HR 2.29, 95%CI 1.22-4.30, p=0.010). The 1-year rate of MACCE was similar between TAVI-noCAD and CAD-noAS patients (9.8% vs. 9.5%, HR 1.05, 95%CI 0.59-1.87, p=0.86). CONCLUSIONS Concomitant CAD in the setting of TAVI conveyed an increased risk of ischemic events and cardiovascular mortality at 1-year follow-up.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Physiology

UniBE Contributor:

Franzone, Anna; Stortecky, Stefan; Räber, Lorenz; Heg, Dierik Hans; Yamaji, Kyohei; Piccolo, Raffaele; Asami, Masahiko; Lanz, Jonas; Praz, Fabien; Koskinas, Konstantinos; Valgimigli, Marco; Pilgrim, Thomas and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

08 Aug 2017 15:27

Last Modified:

08 Sep 2017 19:47

Publisher DOI:

10.1016/j.ijcard.2017.05.071

PubMed ID:

28536005

Additional Information:

Franzone and Stortecky contributed equally to this work.

Uncontrolled Keywords:

Coronary artery disease Mortality Prognosis Transcatheter aortic valve implantation

BORIS DOI:

10.7892/boris.102368

URI:

https://boris.unibe.ch/id/eprint/102368

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