Abstract
Background: Coronary artery disease (CAD) commonly coexists with degenerative aortic stenosis. The impact of CAD in patients undergoing transcatheter aortic valve implantation (TAVI) raises concerns due to the lack of comprehensive and consistent data on this topic. We sought to evaluate the impact of CAD on clinical outcomes in patients undergoing TAVI. Methods: Consecutive patients(N = 663) who underwent TAVI with the 18-French CoreValve ReValving System (CRS) (Medtronic Inc, MN USA) from June 2007 through December 2009 at 14 institutions across Italy were included in this prospective web-based registry. Four patients were excluded from the analysis due to failure to successfully release the prosthesis inside the native aortic valve. Previous percutaneous or surgical myocardial revascularizations were used to identify the existence of concomitant CAD (N = 251; 38%). The primary endpoint was the incidence of Major Adverse Cerebrovascular and Cardiac Events (MACCE) and all-cause death in CAD and no-CAD groups. Results: Patients with CAD were no more likely to develop MACCE within 12-months of the procedure than those who did not (CAD group vs no-CAD group, 15.7% vs 18.3%; adjusted hazard ratio [HR] 0.76; 95% confidence interval [CI] 0.42 to 1.36; p = 0.353). The 12-month mortality was 14.5% and 15.9% in CAD group and no-CAD group, respectively (adjusted HR 0.74; 95% CI 0.40 to 1.36; p = 0.331). Conclusions: Coexisting CAD does not impact procedural outcomes and mid-term incidence of MACCE and survival in elderly patients undergoing TAVI with CRS prosthesis.
| Original language | English |
|---|---|
| Pages (from-to) | 943-950 |
| Number of pages | 8 |
| Journal | International Journal of Cardiology |
| Volume | 167 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Aug 10 2013 |
Fingerprint
Keywords
- Aortic stenosis
- Atherosclerosis
- Coronary artery disease
- TAVI
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Impact of coronary artery disease in elderly patients undergoing transcatheter aortic valve implantation : Insight from the Italian CoreValve Registry. / Ussia, Gian Paolo; Barbanti, Marco; Colombo, Antonio; Tarantini, Giuseppe; Petronio, Anna Sonia; Ettori, Federica; Ramondo, Angelo; Santoro, Gennaro; Klugmann, Silvio; Bedogni, Francesco; Antoniucci, David; Maisano, Francesco; Marzocchi, Antonio; Poli, Arnaldo; De Carlo, Marco; Fiorina, Claudia; De Marco, Federico; Napodano, Massimo; Violini, Roberto; Bortone, Alessandro Santo; Tamburino, Corrado.
In: International Journal of Cardiology, Vol. 167, No. 3, 10.08.2013, p. 943-950.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of coronary artery disease in elderly patients undergoing transcatheter aortic valve implantation
T2 - Insight from the Italian CoreValve Registry
AU - Ussia, Gian Paolo
AU - Barbanti, Marco
AU - Colombo, Antonio
AU - Tarantini, Giuseppe
AU - Petronio, Anna Sonia
AU - Ettori, Federica
AU - Ramondo, Angelo
AU - Santoro, Gennaro
AU - Klugmann, Silvio
AU - Bedogni, Francesco
AU - Antoniucci, David
AU - Maisano, Francesco
AU - Marzocchi, Antonio
AU - Poli, Arnaldo
AU - De Carlo, Marco
AU - Fiorina, Claudia
AU - De Marco, Federico
AU - Napodano, Massimo
AU - Violini, Roberto
AU - Bortone, Alessandro Santo
AU - Tamburino, Corrado
PY - 2013/8/10
Y1 - 2013/8/10
N2 - Background: Coronary artery disease (CAD) commonly coexists with degenerative aortic stenosis. The impact of CAD in patients undergoing transcatheter aortic valve implantation (TAVI) raises concerns due to the lack of comprehensive and consistent data on this topic. We sought to evaluate the impact of CAD on clinical outcomes in patients undergoing TAVI. Methods: Consecutive patients(N = 663) who underwent TAVI with the 18-French CoreValve ReValving System (CRS) (Medtronic Inc, MN USA) from June 2007 through December 2009 at 14 institutions across Italy were included in this prospective web-based registry. Four patients were excluded from the analysis due to failure to successfully release the prosthesis inside the native aortic valve. Previous percutaneous or surgical myocardial revascularizations were used to identify the existence of concomitant CAD (N = 251; 38%). The primary endpoint was the incidence of Major Adverse Cerebrovascular and Cardiac Events (MACCE) and all-cause death in CAD and no-CAD groups. Results: Patients with CAD were no more likely to develop MACCE within 12-months of the procedure than those who did not (CAD group vs no-CAD group, 15.7% vs 18.3%; adjusted hazard ratio [HR] 0.76; 95% confidence interval [CI] 0.42 to 1.36; p = 0.353). The 12-month mortality was 14.5% and 15.9% in CAD group and no-CAD group, respectively (adjusted HR 0.74; 95% CI 0.40 to 1.36; p = 0.331). Conclusions: Coexisting CAD does not impact procedural outcomes and mid-term incidence of MACCE and survival in elderly patients undergoing TAVI with CRS prosthesis.
AB - Background: Coronary artery disease (CAD) commonly coexists with degenerative aortic stenosis. The impact of CAD in patients undergoing transcatheter aortic valve implantation (TAVI) raises concerns due to the lack of comprehensive and consistent data on this topic. We sought to evaluate the impact of CAD on clinical outcomes in patients undergoing TAVI. Methods: Consecutive patients(N = 663) who underwent TAVI with the 18-French CoreValve ReValving System (CRS) (Medtronic Inc, MN USA) from June 2007 through December 2009 at 14 institutions across Italy were included in this prospective web-based registry. Four patients were excluded from the analysis due to failure to successfully release the prosthesis inside the native aortic valve. Previous percutaneous or surgical myocardial revascularizations were used to identify the existence of concomitant CAD (N = 251; 38%). The primary endpoint was the incidence of Major Adverse Cerebrovascular and Cardiac Events (MACCE) and all-cause death in CAD and no-CAD groups. Results: Patients with CAD were no more likely to develop MACCE within 12-months of the procedure than those who did not (CAD group vs no-CAD group, 15.7% vs 18.3%; adjusted hazard ratio [HR] 0.76; 95% confidence interval [CI] 0.42 to 1.36; p = 0.353). The 12-month mortality was 14.5% and 15.9% in CAD group and no-CAD group, respectively (adjusted HR 0.74; 95% CI 0.40 to 1.36; p = 0.331). Conclusions: Coexisting CAD does not impact procedural outcomes and mid-term incidence of MACCE and survival in elderly patients undergoing TAVI with CRS prosthesis.
KW - Aortic stenosis
KW - Atherosclerosis
KW - Coronary artery disease
KW - TAVI
UR - http://www.scopus.com/inward/record.url?scp=84880920686&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880920686&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2012.03.089
DO - 10.1016/j.ijcard.2012.03.089
M3 - Article
C2 - 22459391
AN - SCOPUS:84880920686
VL - 167
SP - 943
EP - 950
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -