Impact of coronary artery disease on outcomes of severe aortic stenosis treatment with transcatheter aortic valve implantation

Postepy Kardiol Interwencyjnej. 2019;15(2):167-175. doi: 10.5114/aic.2019.84394. Epub 2019 Apr 9.

Abstract

Introduction: The presence of coronary artery disease (CAD) in patients who underwent transcatheter aortic valve implantation (TAVI) may increase in-hospital and long-term mortality.

Aim: To evaluate the impact of CAD in patients who underwent TAVI.

Material and methods: The study group consisted of the first 142 patients treated with TAVI between 26 November 2008 and 31 December 2015. The patients were divided into two groups: group I comprised 103 (72.5%) patients with CAD, and group II comprised 39 (27.5%) patients without CAD.

Results: Group I was characterized by a significantly higher risk according to EuroSCORE - 11.2 ±2.5 vs. 9 ±2.3 in group II (p < 0.001) and Logistic EuroSCORE - 25.4 ±13.4 vs. 16.3 ±8.7 (p < 0.001). 30-day mortality was 8 (7.8%) vs. 2 (5.1%) (p = NS) and 1-year mortality was 22 (21.4%) vs. 6 (15.4%) (p = NS) in group I and II respectively. The composite endpoint evaluating the efficacy of TAVI was achieved in 82 (79.6%) vs. 31 (79.5%) (p = NS) in group I and II respectively. The composite endpoint, which involved 30-day observation, occurred in 39 (37.86%) vs. 12 (30.77%) (p = NS) and the composite endpoint, which involved 1-year evaluation of the clinical efficacy of TAVI, occurred in 48 (57.8%) vs. 13 (48.1%) (p = NS) in patients with and without CAD respectively.

Conclusions: The short- and mid-term outcomes of TAVI patients with CAD, despite higher risk profile, did not differ from the outcomes of treatment in patients without CAD.

Keywords: coronary artery bypass graft; coronary artery disease; percutaneous coronary intervention; transcatheter aortic valve implantation.