Clinical impact of complex percutaneous coronary intervention in the pre-TAVR workup

被引：2

作者：

Avvedimento, Marisa ^{[1
]}

Campelo-Parada, Francisco ^{[2
]}

Nombela-Franco, Luis ^{[3
]}

Fischer, Quentin ^{[4
]}

Donaint, Pierre ^{[5
]}

Serra, Vicenc ^{[6
]}

Veiga, Gabriela ^{[7
]}

Gutierrez, Enrique ^{[8
]}

Franzone, Anna ^{[9
]}

Vilalta, Victoria ^{[10
]}

Alperi, Alberto ^{[11
]}

Regueiro, Ander ^{[12
]}

Asmarats, Lluis ^{[13
]}

Ribeiro, Henrique B. ^{[14
]}

Matta, Anthony ^{[2
]}

Munoz-Garcia, Antonio ^{[15
]}

Tirado, Gabriela ^{[3
]}

Urena, Marina ^{[4
]}

Metz, Damien ^{[5
]}

Rodenas-Alesina, Eduard ^{[6
]}

Hernandez, Jose Maria de la Torre ^{[7
]}

Angellotti, Domenico ^{[9
]}

Fernandez-Nofrerias, Eduard ^{[10
]}

Pascual, Isaac ^{[11
]}

Vidal-Cales, Pablo ^{[12
]}

Arzamendi, Dabit ^{[13
]}

Campanha-Borges, Diego Carter ^{[14
]}

Trinh, Kim Hoang ^{[1
]}

Nuche, Jorge ^{[1
]}

Cote, Melanie ^{[1
]}

Faroux, Laurent ^{[5
]}

Rodes-Cabaua, Josep ^{[1
,12
]}

机构：

[1] Laval Univ, Quebec Heart & Lung Inst, Quebec City, PQ, Canada

[2] Hop Univ Toulouse, Cardiol Dept, Toulouse, France

[3] Hosp Clin San Carlos, Inst Cardiovasc, Serv Cardiol, IdISSC, Madrid, Spain

[4] Hopitaux Paris, AP HP, Grp Hosp Bichat Claude Bernard, F-75877 Paris, France

[5] Reims Univ Hosp, Cardiol Dept, F-51100 Reims, France

[6] Hosp Univ Vall dHebron, Serv Cardiol, Barcelona, Spain

[7] Hosp Marques Valdecilla, Serv Cardiol, Santander, Cantabria, Spain

[8] Hosp Gregorio Maranon, Serv Cardiol, Madrid, Spain

[9] Univ Naples Federico II, Dept Adv Biomed Sci, Naples, Italy

[10] Hosp Badalona Germans Trias & Pujol, Serv Cardiol, Badalona, Barcelona, Spain

[11] Hosp Univ Cent Asturias, Serv Cardiol, Oviedo, Asturias, Spain

[12] Inst Invest Biomed August Pi & Sunyer IDIBAPS, Serv Cardiol, Hosp Clin, Inst Clin Cardiovasc, Barcelona, Spain

[13] Hosp Santa Creu & Sant Pau, Serv Cardiol, Barcelona, Spain

[14] Univ Sao Paulo, Heart Inst InCor, Dept Clin Cardiol, Sao Paulo, Brazil

[15] Hosp Univ Virgen Victoria, Serv Cardiol, Malaga, Spain

来源：

REVISTA ESPANOLA DE CARDIOLOGIA | 2025年 / 78卷 / 02期

关键词：

Transcatheter aortic valve replacement; Percutaneous coronary intervention; TAVR; PCI; Complex PCI; AORTIC-VALVE IMPLANTATION; DUAL ANTIPLATELET THERAPY; STENT THROMBOSIS; REVASCULARIZATION; MONOTHERAPY; OUTCOMES; DISEASE;

D O I：

10.1016/j.rec.2024.05.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction and objectives: In patients undergoing percutaneous coronary intervention (PCI) in the workup pre-transcatheter aortic valve replacement (TAVR), the clinical impact of coronary revascularization complexity remains unknown. This study sought to examine the impact of PCI complexity on clinical outcomes after TAVR in patients undergoing PCI in the preprocedural workup. Methods: This was a multicenter study including consecutive patients scheduled for TAVR with concomitant significant coronary artery disease. Complex PCI was defined as having at least 1 of the following features: 3 vessels treated, >= 3 stents implanted,>= 3 lesions treated, bifurcation with 2 stents implanted, total stent length > 60 mm, or chronic total occlusion. The rates of major adverse cardiac events (MACE), including cardiovascular mortality, myocardial infarction, and coronary revascularization were evaluated. Results: A total of 1550 patients were included, of which 454 (29.3%) underwent complex PCI in the preTAVR workup. After a median follow-up period of 2 [1-3] years after TAVR, the incidence of MACE was 9.6 events per 100 patients-years. Complex PCI significantly increased the risk of cardiac death (HR, 1.44; 95%CI, 1.01-2.07), nonperiprocedural myocardial infarction (HR, 1.52; 95%CI, 1.04-2.21), and coronary revascularization (HR, 2.46; 95%CI, 1.44-4.20). In addition, PCI complexity was identified as an independent predictor of MACE after TAVR (HR, 1.31; 95%CI, 1.01-1.71; P = .042). Conclusions: In TAVR candidates with significant coronary artery disease requiring percutaneous treatment, complex revascularization was associated with a higher risk of MACE. The degree of procedural complexity should be considered a strong determinant of prognosis in the PCI-TAVR population. (C) 2024 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

引用

页码：82 / 93

页数：12

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