June 30, 2016Journal of Interventional Cardiology
Impact of Coronary Artery Disease Burden on 12‐Month Mortality of Patients After Transcatheter Aortic Valve Implantation
Key result
Incomplete coronary revascularization before TAVI was associated with higher 12-month all-cause mortality compared to complete revascularization or no significant lesions (75.0% vs 7.1%; HR 10.86).
Why the study?
Does incomplete coronary revascularization increase 12-month all-cause mortality in patients undergoing TAVI?
Population
101 consecutive patients with severe aortic stenosis undergoing transcatheter aortic valve implantation.
Comparison
Incomplete coronary revascularization prior to… vs Complete coronary revascularization or without…
Design
Cohort
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
Should not yet guide revascularization decisions in TAVI; leaves open whether completeness improves survival in RCTs.
Study Design
Type
Cohort (n=101)
Structured PICO
Does incomplete coronary revascularization increase 12-month all-cause mortality in patients undergoing TAVI?
P
Population
101 consecutive patients with severe aortic stenosis undergoing TAVI, followed for 12 months.
E
Exposure
Incomplete coronary revascularization prior to TAVI
C
Comparator
Complete coronary revascularization or without significant coronary lesions prior to TAVI
O
Outcome
12-month all-cause mortalityhard clinical
Main Result
Hazard Ratio: 10.86 (95% CI 3.72–31.73)
Absolute Event Rate: 75% vs 7.1%
p-value: p=< 0.001
Incomplete coronary revascularization prior to TAVI is strongly associated with increased 12-month all-cause mortality, highlighting the importance of managing coronary artery disease burden in this population.
Limitations
- Further studies are recommended to confirm the results, especially regarding the impact of chronic total occlusions on long-term mortality.
Cite This Study
Kleczyński et al. (2016) conducted a cohort in Severe aortic stenosis undergoing TAVI (n=101). Incomplete coronary revascularization vs. Complete coronary revascularization or without significant lesions was evaluated on 12-month all-cause mortality (HR 10.86, 95% CI 3.72-31.73, p=< 0.001). Incomplete coronary revascularization before TAVI was associated with higher 12-month all-cause mortality compared to complete revascularization or no significant lesions (75.0% vs 7.1%; HR 10.86).