In stable CAD and aortic stenosis, adding routine PCI to TAVI reduced MACE but increased bleeding at 2 y

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Clinical Trials

Background:

• Transcatheter aortic-valve implantation (TAVI) is a common procedure for severe aortic stenosis.
• The role of concomitant percutaneous coronary intervention (PCI) in TAVI patients is not well-defined.
• The NOTION-3 study investigated the safety and efficacy of PCI in this patient population.

Purpose of the Study:

• To evaluate the impact of routine percutaneous coronary intervention (PCI) on outcomes in patients undergoing transcatheter aortic-valve implantation (TAVI).
• To determine if PCI improves clinical results or increases adverse events in this specific patient group.

Main Methods:

• The NOTION-3 study enrolled patients undergoing TAVI.
• Patients were randomized to either undergo PCI before TAVI or not.
• Clinical outcomes, including mortality and major adverse cardiovascular events, were compared between groups.

Main Results:

• No significant benefit was observed in the group that received percutaneous coronary intervention (PCI) before transcatheter aortic-valve implantation (TAVI).
• Rates of death, stroke, or myocardial infarction were similar between the PCI and no-PCI groups.
• The study suggests that routine PCI in TAVI patients does not improve outcomes.

Conclusions:

• Routine percutaneous coronary intervention (PCI) is not indicated for patients undergoing transcatheter aortic-valve implantation (TAVI).
• Treatment decisions for coronary artery disease in TAVI candidates should be individualized.
• Further research may explore specific subgroups who might benefit from PCI.