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Coronary artery disease and outcomes following transcatheter aortic valve implantation

Sameer Kurmani1, Bhavik Modi2, Aditya Mukherjee2

  • 1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK skurmani1984@gmail.com.

Open Heart
|March 29, 2024
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) patients with coronary artery disease (CAD) did not experience increased mortality or hospital readmissions. This study found no significant association between coexistent CAD and outcomes after TAVI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Aortic stenosis is a serious condition often treated with transcatheter aortic valve implantation (TAVI).
  • Coronary artery disease (CAD) is common in TAVI patients, but its impact on outcomes is unclear.
  • Optimal management strategies for TAVI patients with CAD require further investigation.

Purpose of the Study:

  • To investigate the association between coexistent coronary artery disease (CAD) and mortality in patients undergoing transcatheter aortic valve implantation (TAVI).
  • To evaluate the impact of CAD on hospital readmission rates, including all-cause, Major Adverse Cardiovascular Event (MACE), and acute coronary syndrome, following TAVI.
  • To assess the influence of CAD on patient-reported symptoms such as angina and breathlessness post-TAVI.

Main Methods:

  • An observational cohort study involving 898 patients who underwent TAVI.
  • Patients were categorized based on the presence or absence of obstructive epicardial coronary artery disease (CAD).
  • Primary outcome was 3-year mortality; secondary outcomes included various hospital readmission endpoints and symptom scores.

Main Results:

  • Of 898 TAVI patients, 410 (45.7%) had obstructive CAD. No significant difference in 3-year mortality was observed between patients with and without CAD (32.9% vs. 33.2%).
  • Multivariate analysis confirmed that CAD presence did not significantly affect mortality (HR 0.98, CI 0.68 to 1.40).
  • Readmission rates for all causes, MACE, and acute coronary syndrome, as well as angina and breathlessness scores, showed no significant differences between groups.

Conclusions:

  • Coexistent coronary artery disease (CAD) does not significantly impact 3-year mortality in patients undergoing transcatheter aortic valve implantation (TAVI).
  • The presence of CAD is not associated with increased rates of all-cause or MACE-related hospital readmissions after TAVI.
  • Coronary artery disease does not significantly affect symptom burden, including angina and breathlessness, in patients treated with TAVI.
Abstract

Keywords:
Aortic Valve StenosisCORONARY ARTERY DISEASETranscatheter Aortic Valve Replacement

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