Percutaneous coronary intervention in TAVI candidates with coronary artery disease did not significantly reduce all-cause death (OR 0.88; 95% CI 0.62-1.25) compared to conservative management.
Meta-Analysis (n=1,156)
Does percutaneous coronary intervention reduce mortality or cardiovascular events in transcatheter aortic valve implantation candidates with coronary artery disease?
In TAVI candidates with coronary artery disease, performing PCI does not significantly reduce mortality or myocardial infarction but is associated with a significant reduction in stroke and a trend toward increased bleeding.
Odds Ratio: 0.88 (95% CI 0.62–1.25)
Coronary artery disease coexists in approximately 50% of transcatheter aortic valve implantation candidates, yet the role of percutaneous coronary intervention (PCI) remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing PCI with conservative management or deferral in transcatheter aortic valve implantation candidates with coronary artery disease. We searched 4 databases from inception to June 19, 2026. Odds ratios (ORs) were pooled using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp-Sidik-Jonkman adjustment. Individual patient data were reconstructed from published Kaplan-Meier curves. Risk of bias and certainty of evidence were assessed. Three randomized controlled trials (n = 1156 patients) were included. PCI showed no significant reductions in all-cause death (OR 0.88; 95% confidence interval CI, 0.62-1.25; I2 = 0%), cardiovascular death (OR 0.72; 95% CI, 0.40-1.29; I2 = 0%), or myocardial infarction (OR 0.85; 95% CI, 0.17-4.18; I2 = 51.8%). Stroke was significantly reduced with PCI (OR 0.68; 95% CI, 0.48-0.95; I2 = 0%). PCI was associated with a trend toward increased any bleeding (OR 2.26; 95% CI, 0.81-6.29; I2 = 69.8%) and major bleeding (OR 1.70; 95% CI, 0.63-4.60; I2 = 35.9%).
Yassin et al. (2026) conducted a meta-analysis in transcatheter aortic valve implantation candidates with coronary artery disease (n=1,156). percutaneous coronary intervention (PCI) vs. conservative management or deferral was evaluated on all-cause death (OR 0.88, 95% CI 0.62-1.25). Percutaneous coronary intervention in TAVI candidates with coronary artery disease did not significantly reduce all-cause death (OR 0.88; 95% CI 0.62-1.25) compared to conservative management.