eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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3/2023
vol. 19
 
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abstract:
Original paper

Impact of previous coronary artery revascularization on outcomes in patients undergoing transcatheter aortic valve implantation

Radosław Wilimski
1
,
Zenon Huczek
2
,
Kamil Krauz
1
,
Bartosz Rymuza
2
,
Maciej Mazurek
2
,
Piotr Scisło
2
,
Karol Zbroński
2
,
Kajetan Grodecki
2
,
Janusz Kochman
2
,
Mariusz Kuśmierczyk

  1. Department of Cardio-Thoracic Surgery and Transplantology, Medical University of Warsaw, Warsaw, Poland
  2. 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Adv Interv Cardiol 2023; 19, 3 (73): 243–250
DOI: https://doi.org/10.5114/aic.2023.131477
Online publish date: 2023/09/27
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Introduction:
transcatheter aortic valve implantation (TAVI) raises questions regarding the safety and efficacy of TAVI in this subset of patients.

Aim:
To evaluate the impact of previous coronary revascularization in terms of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) on clinical outcomes after TAVI.

Material and methods:
A total of 507 consecutive patients who underwent TAVI were divided into: non-revascularization (NR), post-PCI and post-CABG groups. The endpoints were established according to VARC-2 definitions.

Results:
Patients with previous coronary revascularization (36.7% of the population) were younger, more often male and their EuroSCORE II risk evaluation was significantly higher (NR 7.9% vs. post-PCI 8.0% vs. post-CABG 20.5%, p < 0.0001). Patients after PCI or CABG prior to TAVI had similar 30-day all-cause mortality rates as those without coronary revascularization at baseline (NR vs. post-PCI vs. post-CABG: 8.1% vs. 5.5% vs. 6.8%, respectively; p = 0.6). There were no differences in 12-month all-cause mortality rates between groups (NR vs. post-PCI vs. post-CABG: 15.3% vs. 14.2% vs. 16.9%, respectively; log-rank p = 0.67). In the Cox proportional-hazards regression model, acute kidney injury stage 2-3 (HR = 3.7, 95% CI: 2.14–6.33; p < 0.001) and post-TAVI stroke (HR = 3.5, 95% CI: 1.57–7.8; p = 0.002) were independently correlated with 1-year mortality.

Conclusions:
TAVI seems to be a safe and effective procedure for the treatment of severe AS in patients with previous coronary revascularization.

keywords:

percutaneous coronary intervention, coronary artery bypass grafting, transcatheter aortic valve implantation, coronary artery disease
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