Key Points
- To assess the prognostic impact of coronary artery disease severity and revascularization completeness on two-year clinical outcomes in patients undergoing transcatheter aortic valve replacement.
- Analyzed 287 consecutive patients undergoing transcatheter aortic valve replacement (TAVR) at a single institution, stratified by the presence of coronary artery disease (CAD).
- Quantified baseline CAD severity and revascularization completeness using the SYNTAX score (SS), clinical SYNTAX score (cSS), and residual SYNTAX score (rSS).
- Compared clinical outcomes at 2 years between patients without CAD and CAD subgroups stratified by SS, cSS, and rSS cutoffs.
- Patients with CAD experienced significantly higher 2-year primary endpoint rates than patients without CAD (28.3% vs. 16.1%, P=0.026).
- Adverse outcomes were driven by high CAD severity (75.0% vs. 16.1%, P=0.002 for SS > 22; 41.2% vs. 16.1%, P=0.001 for cSS > 63), whereas low-severity CAD showed event rates comparable to no CAD.
- Complete or near-complete revascularization attenuated CAD-associated risk, with patients achieving an rSS < 8 demonstrating outcomes no worse than patients without CAD.
Structured PICO
Does coronary artery disease severity and completeness of revascularization affect 2-year clinical outcomes in patients undergoing TAVR?
PPopulation287 consecutive patients undergoing transcatheter aortic valve replacement (TAVR) at a single institution
IInterventionPresence of coronary artery disease (CAD) stratified by severity using SYNTAX score (SS) and clinical SYNTAX score (cSS), and completeness of revascularization using residual SYNTAX score (rSS)
CComparatorPatients without coronary artery disease (CAD)
OOutcomePrimary endpoint at 2 years (specific components not defined in abstract)
In patients undergoing TAVR, high-severity CAD is associated with worse 2-year prognosis, but more complete revascularization (residual SYNTAX score < 8) attenuates this risk to levels comparable to patients without CAD.