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Impact of coronary artery disease and percutaneous coronary intervention in women undergoing transcatheter aortic valve replacement: From the WIN‐TAVI registry
Author(s) -
Guedeney Paul,
Tchétché Didier,
Petronio Anna Sonia,
Mehilli Julinda,
Sartori Samantha,
Lefèvre Thierry,
Presbitero Patrizia,
Capranzano Piera,
Iadanza Alessandro,
Sardella Gennaro,
Van Mieghem Nicolas M.,
Sorrentino Sabato,
Claessen Bimmer E. P. M.,
Chandrasekhar Jaya,
Vogel Birgit,
Kalkman Deborah N.,
Meliga Emanuele,
Dumonteil Nicolas,
Fraccaro Chiara,
Trabattoni Daniela,
Mikhail Ghada,
FerrerGrazia MariaCruz,
Naber Christoph,
Kievit Peter,
Baber Usman,
Sharma Samin,
Morice MarieClaude,
Chieffo Alaide,
Mehran Roxana
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28012
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , coronary artery disease , cardiology , valve replacement , myocardial infarction , stroke (engine) , surgery , stenosis , mechanical engineering , engineering
Objectives To evaluate the impact of coronary artery disease (CAD) with or without recent (≤ 30 days) percutaneous coronary intervention (PCI) in women undergoing transcatheter aortic valve replacement (TAVR). Background Although women display a specific risk‐profile for both PCI and TAVR, the impact of CAD and PCI in the setting of TAVR in women is unclear. Methods The multinational Women's International Transcatheter Aortic Valve implantation registry enrolled consecutive female patients undergoing contemporary TAVR in 19 centers between 2013 and 2015. Patients with available coronary angiography or CT scan in the pre‐operative assessment of TAVR were categorized as without CAD, with CAD but no recent PCI and CAD and recent PCI (≤30 days). All events were adjudicated according to the VARC‐2 criteria. Results A total of 787 patients were included in this analysis, among whom 459 (58.3%) had no CAD, 247 (31.4%) had CAD without recent PCI and 81 (10.3%) underwent recent PCI (≤ 30 days before TAVR). After multivariable adjustment, both groups of CAD patients, without and with recent PCI, presented with higher risk of death, myocardial infarction or stroke, compared with patients without CAD ( adj HR 1.56, 95%CI 1.03–2.39, P = 0.038 and adj HR 1.96, 95% CI 1.1–3.5, P = .021, respectively). Patients with recent PCI had increased risk of all‐cause death ( adj HR 1.89, 95% CI 1.0–3.5, P = 0.04) and stroke ( adj HR 3.7, 95% CI 1.0–13.5, P = 0.046) compared with patients without CAD. Conclusion The presence of CAD in women undergoing TAVR, with or without recent PCI, was associated with long‐term poorer outcomes.