Angina in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement

Introduction and objectives: To evaluate the prevalence, clinical characteristics, and outcomes of patients with angina undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. Methods: A total of 1687 consecutive patients with severe aortic stenosis undergoing TAVR at our center were included and classified according to patient-reported angina symptoms prior to the TAVR procedure. Baseline, procedural and follow-up data were collected in a dedicated database. Results: A total of 497 patients (29%) had angina prior to the TAVR procedure. Patients with angina at baseline showed a worse New York Heart Association (NYHA) functional class (NYHA class > II: 69% vs 63%; P =.017), a higher rate of coronary artery disease (74% vs 56%; P <.001), and a lower rate of complete revascularization (70% vs 79%; P <.001). Angina at baseline had no impact on all-cause mortality (HR, 1.02; 95%CI, 0.71-1.48; P =.898) and cardiovascular mortality (HR, 1.2; 95%CI, 0.69-2.11; P =.517) at 1 year. However, persistent angina at 30 days post-TAVR was associated with increased all-ause mortality (HR, 4.86; 95%CI, 1.71-13.8; P =.003) and cardiovascular mortality (HR, 20.7; 95%CI, 3.50-122.6; P =.001) at 1-year follow-up. Conclusions: More than one-fourth of patients with severe aortic stenosis undergoing TAVR had angina prior to the procedure. Angina at baseline did not appear to be a sign of a more advanced valvular disease and had no prognostic impact; however, persistent angina at 30 days post-TAVR was associated with worse clinical outcomes. (c) 2023 Sociedad Espanola de Cardiologi ' a. Published by Elsevier Espana, S.L.U. All rights reserved.