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Calcium channel blocker use and outcomes following transcatheter aortic valve intervention for aortic stenosis

Daisuke Miyahara1, Masaki Izumo2, Yukio Sato1

  • 1Department of Cardiology, St. Marianna University School of Medicine, 2-16-1, Sugao,Miyamae-ku, Kawasaki, 216-8511, Japan.

Cardiovascular Intervention and Therapeutics
|February 3, 2025
PubMed

Insights

Calcium channel blockers (CCBs) did not worsen outcomes for patients after transcatheter aortic valve intervention (TAVI) for severe aortic stenosis (AS). However, CCBs may improve prognosis in TAVI patients with coronary artery disease (CAD).

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Calcium channel blockers (CCBs) are standard treatments for coronary artery disease (CAD).
  • The impact of CCBs on patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve intervention (TAVI) remains underexplored.
  • Understanding CCB effects post-TAVI is crucial for optimizing patient management.

Purpose of the Study:

  • To investigate the association between CCB use and clinical outcomes in patients with severe AS after TAVI.
  • To evaluate the safety and potential benefits of CCBs in this specific patient population.

Main Methods:

  • Retrospective observational study of 993 patients undergoing TAVI for severe AS (January 2017 - July 2023).
  • Follow-up for all-cause mortality and heart failure hospitalisation.
  • Propensity score matching (PSM) to compare outcomes between patients with and without CCBs at discharge.

Main Results:

  • CCBs were used in 59.4% of patients post-TAVI.
  • After PSM, no significant difference in the composite endpoint (mortality/heart failure hospitalization) was observed between CCB users and non-users (HR=0.879, p=0.409).
  • Subgroup analysis indicated a potential benefit of CCBs in patients with concomitant coronary artery disease (p-interaction=0.002).

Conclusions:

  • CCB use is not associated with worse clinical outcomes in patients following TAVI for severe AS.
  • CCBs may offer a prognostic advantage for TAVI patients with concurrent coronary artery disease.
  • Further research is warranted to confirm these findings and guide clinical practice.

Keywords:
Aortic stenosisCalcium channel blockerCoronary artery diseaseTranscatheter aortic valve intervention

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