What does this research mean for the field?

Patients with obstructive CAD and those without had similar improvements in health status and clinical efficacy after TAVI, with no increased risk observed. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

This research investigates how obstructive coronary artery disease affects clinical and health outcomes in patients undergoing transcatheter aortic valve implantation.

February 8, 2026

Impact of obstructive coronary artery disease on clinical and health status in patients undergoing transcatheter aortic valve implantation

Resultado clave

Obstructive CAD did not affect 3-year post-TAVI clinical efficacy or patient-reported health status improvements, with HR 1.13 and RR 0.98 indicating similar outcomes.

Puntos clave

This research investigates how obstructive coronary artery disease affects clinical and health outcomes in patients undergoing transcatheter aortic valve implantation.
Patients were categorized by the presence of obstructive CAD defined as >50% stenosis in a major coronary vessel.
Outcomes evaluated included patient-reported health status and clinical efficacy as per VARC-3 guidelines.
The SCOPE I trial data was used for analysis.
Obstructive CAD was found in 51.0% of patients undergoing TAVI.
Patients with obstructive CAD showed similar improvements in health status and mortality rates compared to non-CAD patients after 3 years.
Both groups exhibited comparable clinical efficacy, with no significant differences observed.

PICO estructurado

Does obstructive coronary artery disease impact clinical efficacy and patient-reported health status in patients undergoing TAVI?

Población

732 patients who initiated transcatheter aortic valve implantation (TAVI) in the SCOPE I trial

Intervención

Presence of obstructive coronary artery disease (CAD), defined as stenosis > 50% in at least one major epicardial coronary vessel (n=373)

Comparador

Absence of obstructive coronary artery disease (n=359)

Resultado

Vital and patient-reported disease-specific health status, and clinical efficacy according to the Valve Academic Research Consortium (VARC)-3 definition (freedom from all-cause mortality, freedom from all stroke, freedom from hospitalization for procedure- or valve-related causes, and an overall KCCQ score ≥45 without a decline of >10 points from baseline) at 3 yearscomposite

The presence of obstructive coronary artery disease does not negatively impact 3-year clinical efficacy or patient-reported health status in patients undergoing TAVI.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Abstract Background Aortic stenosis and obstructive coronary artery disease (CAD) frequently coexist. However, the impact of obstructive CAD on clinical and patient-reported outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) remains unclear. Objectives To investigate the impact of obstructive CAD on clinical and patient-reported outcomes in patients undergoing TAVI. Methods Patients in the SCOPE I (Safety and Efficacy of the ACURATE Neo/TF Compared to the SAPIEN 3 Bioprosthesis) trial were stratified according to obstructive CAD, defined as stenosis 50% in at least one major epicardial coronary vessel. Outcomes of interest included vital and patient-reported disease-specific health status, as well as clinical efficacy according to the Valve Academic Research Consortium (VARC)-3 definition (freedom from all-cause mortality, freedom from all stroke, freedom from hospitalization for procedure- or valve-related causes, and an overall Kansas City Cardiomyopathy Questionnaire KCCQ score ≥45 without a decline of 10 points in the overall KCCQ score from baseline). Results Among 732 patients initiated TAVI, obstructive CAD was identified in 373 patients (51.0%). Of 373 patients with obstructive CAD, 144 (38.6%) underwent percutaneous coronary intervention (PCI) in the periprocedural period. Patients with obstructive CAD were more likely to be male (54.4% vs. 31.5%, P 0.001) and had a higher surgical risk (Society of Thoracic Surgeons Predicted Risk of Mortality: 4.5 ± 3.2 vs. 4.0 ± 2.4, P = 0.010) and atherosclerotic comorbidity burden compared with patients without obstructive CAD. Patients with and without obstructive CAD had similar improvements in patient-reported health status measures, all-cause and cardiovascular mortality (HR 1.13, 95% CI 0.83-1.53; and HR 1.13, 95% CI 0.78-1.64, respectively), and VARC-3 clinical efficacy (RR 0.98, 95% CI 0.84-1.14) at 3 years after TAVI. These results were consistent when patients with obstructive CAD were stratified according to the PCI performed. Conclusions Patients with and without obstructive CAD had a similar improvement in patient-reported health status measures after TAVI, and obstructive CAD did not confer a risk of diminished clinical efficacy of TAVI throughout 3 years of follow-up.

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Cite This Study

Tomii et al. (Sat,) reported a other. Obstructive CAD did not affect 3-year post-TAVI clinical efficacy or patient-reported health status improvements, with HR 1.13 and RR 0.98 indicating similar outcomes.

synapsesocial.com/papers/6988292d0fc35cd7a88495ac https://doi.org/https://doi.org/10.1093/eurheartj/ehaf784.2366

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