In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
Abstract:
Introduction: It is unclear whether or not percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) yields an incremental benefit to patients with concomitant coronary artery disease (CAD). Hypothesis: We hypothesized that unprotected left main (LM) or proximal left anterior descending artery (pLAD) PCI conducted prior to TAVR is not associated with improved post-procedural clinical outcomes in a Northern New England patient population. Methods: We performed a retrospective study of 2,729 patients undergoing TAVR at 6 medical centers in Northern New England from 2012-2018. From this cohort, we identified patients with unprotected LM 〉 50% and/or pLAD 〉 70% CAD (n=160). We analyzed site variability and compared early outcomes of patients who underwent PCI ≤60 days before TAVR to those who did not. Results: Across 6 hospitals, there was significant variation in the use of PCI before TAVR (range 50%-76%, p for trend=0.361); this variation did not correlate with site TAVR volumes. In this 160 patient cohort, 36.2% had isolated LM 〉 50% and 76% had pLAD 〉 70% disease. The comparator groups were well-matched with respect to age, sex, and medical complexity. There were no significant differences between PCI and non-PCI groups with respect to early mortality, MI, or stroke after TAVR (Table). Conclusion: There is significant variation in revascularization practices before TAVR. The routine performance of unprotected LM or pLAD PCI before TAVR does not affect early post-valve outcomes in patients of Northern New England.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.142.suppl_3.15774
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
1466401-X
Permalink