Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease: A comparative analysis from the Italian OBSERVANT study

OBSERVANT Research Group

Research output: Contribution to journalArticle

Abstract

Background: To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). Methods: Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session. Results: After propensity-score matching, a total of 472 patients (236 per group) were identified. Among TAVI patients, PCI was performed prior to the procedure in 217 patients (92.0%), whereas concomitant TAVI and PCI were performed in 19 patients (8.0%). At 3-year, there was no difference in survival between the two groups (KM estimate of freedom from death for SAVR and TAVI patients of 0.742 and 0.650, respectively; log-rank p-value of 0.105). The rate of MACCE was comparable between the two groups (KM estimate of freedom from MACCE for SAVR and TAVI patients of 0.683 and 0.582, respectively; log-rank p-value of 0.115). Conclusions: In patients with associated severe AS and CAD, percutaneous treatment (TAVR and staged or concomitant PCI) was comparable to surgical treatment (SAVR and concomitant CABG) with respect to the early and mid-term risk of death from any cause, myocardial infarction, stroke and unplanned revascularization.

Original languageEnglish
Pages (from-to)102-106
Number of pages5
JournalInternational Journal of Cardiology
Volume270
DOIs
Publication statusPublished - Nov 1 2018

Fingerprint

Aortic Valve Stenosis
Coronary Artery Disease
Percutaneous Coronary Intervention
Aortic Valve
Surgical Instruments
Coronary Artery Bypass
Therapeutics
Propensity Score
Transcatheter Aortic Valve Replacement
Multicenter Studies
Cause of Death
Stroke
Myocardial Infarction

Keywords

  • Aortic stenosis
  • CABG
  • Coronary artery disease
  • PCI
  • SAVR
  • TAVI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{28a21bf1f3ef4ec2857a990afd59a8e1,
title = "Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease: A comparative analysis from the Italian OBSERVANT study",
abstract = "Background: To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). Methods: Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session. Results: After propensity-score matching, a total of 472 patients (236 per group) were identified. Among TAVI patients, PCI was performed prior to the procedure in 217 patients (92.0{\%}), whereas concomitant TAVI and PCI were performed in 19 patients (8.0{\%}). At 3-year, there was no difference in survival between the two groups (KM estimate of freedom from death for SAVR and TAVI patients of 0.742 and 0.650, respectively; log-rank p-value of 0.105). The rate of MACCE was comparable between the two groups (KM estimate of freedom from MACCE for SAVR and TAVI patients of 0.683 and 0.582, respectively; log-rank p-value of 0.115). Conclusions: In patients with associated severe AS and CAD, percutaneous treatment (TAVR and staged or concomitant PCI) was comparable to surgical treatment (SAVR and concomitant CABG) with respect to the early and mid-term risk of death from any cause, myocardial infarction, stroke and unplanned revascularization.",
keywords = "Aortic stenosis, CABG, Coronary artery disease, PCI, SAVR, TAVI",
author = "{OBSERVANT Research Group} and Marco Barbanti and Sergio Buccheri and Davide Capodanno and Paola D'Errigo and Marco Ranucci and Stefano Rosato and Gennaro Santoro and Danilo Fusco and Corrado Tamburino and Fausto Biancari and Fulvia Seccareccia",
year = "2018",
month = "11",
day = "1",
doi = "10.1016/j.ijcard.2018.06.011",
language = "English",
volume = "270",
pages = "102--106",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease

T2 - A comparative analysis from the Italian OBSERVANT study

AU - OBSERVANT Research Group

AU - Barbanti, Marco

AU - Buccheri, Sergio

AU - Capodanno, Davide

AU - D'Errigo, Paola

AU - Ranucci, Marco

AU - Rosato, Stefano

AU - Santoro, Gennaro

AU - Fusco, Danilo

AU - Tamburino, Corrado

AU - Biancari, Fausto

AU - Seccareccia, Fulvia

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). Methods: Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session. Results: After propensity-score matching, a total of 472 patients (236 per group) were identified. Among TAVI patients, PCI was performed prior to the procedure in 217 patients (92.0%), whereas concomitant TAVI and PCI were performed in 19 patients (8.0%). At 3-year, there was no difference in survival between the two groups (KM estimate of freedom from death for SAVR and TAVI patients of 0.742 and 0.650, respectively; log-rank p-value of 0.105). The rate of MACCE was comparable between the two groups (KM estimate of freedom from MACCE for SAVR and TAVI patients of 0.683 and 0.582, respectively; log-rank p-value of 0.115). Conclusions: In patients with associated severe AS and CAD, percutaneous treatment (TAVR and staged or concomitant PCI) was comparable to surgical treatment (SAVR and concomitant CABG) with respect to the early and mid-term risk of death from any cause, myocardial infarction, stroke and unplanned revascularization.

AB - Background: To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). Methods: Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session. Results: After propensity-score matching, a total of 472 patients (236 per group) were identified. Among TAVI patients, PCI was performed prior to the procedure in 217 patients (92.0%), whereas concomitant TAVI and PCI were performed in 19 patients (8.0%). At 3-year, there was no difference in survival between the two groups (KM estimate of freedom from death for SAVR and TAVI patients of 0.742 and 0.650, respectively; log-rank p-value of 0.105). The rate of MACCE was comparable between the two groups (KM estimate of freedom from MACCE for SAVR and TAVI patients of 0.683 and 0.582, respectively; log-rank p-value of 0.115). Conclusions: In patients with associated severe AS and CAD, percutaneous treatment (TAVR and staged or concomitant PCI) was comparable to surgical treatment (SAVR and concomitant CABG) with respect to the early and mid-term risk of death from any cause, myocardial infarction, stroke and unplanned revascularization.

KW - Aortic stenosis

KW - CABG

KW - Coronary artery disease

KW - PCI

KW - SAVR

KW - TAVI

UR - http://www.scopus.com/inward/record.url?scp=85048271378&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048271378&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2018.06.011

DO - 10.1016/j.ijcard.2018.06.011

M3 - Article

C2 - 29903519

AN - SCOPUS:85048271378

VL - 270

SP - 102

EP - 106

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -