Percutaneous coronary intervention (PCI) can be safely performed before, during, or after transcatheter aortic valve implantation (TAVI) for patients with stable coronary artery disease (CAD), results of an analysis presented at the Society for Cardiovascular Angiography & Interventions (SCAI) 2024 scientific sessions (2–4 May, Long Beach, USA) suggest.
The analysis included 49,344 patients with stable CAD who underwent PCI before (84.7%), after (1.3%), or simultaneously (14%) with TAVI using the Sapien 3 (Edwards Lifesciences) platform balloon expandable bioprosthesis. The analysis was conducted using the TVT Registry and Medicare linkage between 2015 and 2024.
In a propensity-matched analysis, the composite of all-cause mortality and stroke were similar in three groups at three years of follow-up. The authors noted that due to the small numbers of patients undergoing PCIs after the TAVI, when they compared just the two other groups (before and concomitant PCIs), PCI performed before TAVI had a slight advantage over concomitant PCI with TAVI at three years (P=0.012).
“These findings are exciting as they slightly differ from previously published registry data,” said Abhijeet Dhoble (University of Texas Health Science Center, Houston, USA) the lead author of the study. “We believe these data will instil confidence and provide supporting evidence for many physicians and heart teams to make decisions regarding the timing of PCI in patients undergoing TAVI.”
