OBJECTIVE: To examine the prevalence and impact of concomitant coronary artery disease (CAD) on short-term outcome after transcatheter aortic valve implantation (TAVI). BACKGROUND: The prevalence of CAD in patients undergoing surgical aortic valve replacement is estimated at 30-50 % and its presence increases procedural risk. The prevalence and impact of CAD on outcome after TAVI are not well defined. METHODS: We analyzed 1,382 patients enrolled in the German TAVI registry; the majority (81 %) received the Medtronic CoreValve. The presence of coronary lesions with ≥50 % stenosis on pre-TAVI angiography defined the existence of concomitant CAD. RESULTS: 859 patients (62.2 %) had concomitant CAD, of which 534 (62.3 %) had multi-vessel and 83 (9.7 %) left main disease. Patients with CAD were younger (81.5 ± 6.1 vs. 82.1 ± 6.3 years, p < 0.05), more commonly males (49.4 vs. 30.0 %, p < 0.0001) and diabetics (36.9 vs. 31.2 %, p < 0.05), and had a worse Canadian Cardiovascular Society angina class at baseline compared to patients with no CAD. During TAVI patients with CAD more often required additional coronary intervention and had longer procedures, but procedural success rates were similar (97.1 vs. 97.7 %). Crude in-hospital mortality was higher in patients with CAD (10.0 vs. 5.5 %, OR 1.90, 95 % CI 1.23-2.93), but this was not significant after adjustment for confounders (adjusted OR 1.41, 95 % CI 0.85-2.33). Both groups had significant improvement in 30-day symptoms and quality of life. CONCLUSION: The prevalence of CAD in contemporary TAVI patients is high. Its presence characterizes a high-risk population and is associated with increased crude short-term mortality, largely explained by co-morbidities, but does not limit functional improvement after TAVI.
OBJECTIVE: To examine the prevalence and impact of concomitant coronary artery disease (CAD) on short-term outcome after transcatheter aortic valve implantation (TAVI). BACKGROUND: The prevalence of CAD in patients undergoing surgical aortic valve replacement is estimated at 30-50 % and its presence increases procedural risk. The prevalence and impact of CAD on outcome after TAVI are not well defined. METHODS: We analyzed 1,382 patients enrolled in the German TAVI registry; the majority (81 %) received the Medtronic CoreValve. The presence of coronary lesions with ≥50 % stenosis on pre-TAVI angiography defined the existence of concomitant CAD. RESULTS: 859 patients (62.2 %) had concomitant CAD, of which 534 (62.3 %) had multi-vessel and 83 (9.7 %) left main disease. Patients with CAD were younger (81.5 ± 6.1 vs. 82.1 ± 6.3 years, p < 0.05), more commonly males (49.4 vs. 30.0 %, p < 0.0001) and diabetics (36.9 vs. 31.2 %, p < 0.05), and had a worse Canadian Cardiovascular Society angina class at baseline compared to patients with no CAD. During TAVI patients with CAD more often required additional coronary intervention and had longer procedures, but procedural success rates were similar (97.1 vs. 97.7 %). Crude in-hospital mortality was higher in patients with CAD (10.0 vs. 5.5 %, OR 1.90, 95 % CI 1.23-2.93), but this was not significant after adjustment for confounders (adjusted OR 1.41, 95 % CI 0.85-2.33). Both groups had significant improvement in 30-day symptoms and quality of life. CONCLUSION: The prevalence of CAD in contemporary TAVI patients is high. Its presence characterizes a high-risk population and is associated with increased crude short-term mortality, largely explained by co-morbidities, but does not limit functional improvement after TAVI.
Authors: Craig R Smith; Martin B Leon; Michael J Mack; D Craig Miller; Jeffrey W Moses; Lars G Svensson; E Murat Tuzcu; John G Webb; Gregory P Fontana; Raj R Makkar; Mathew Williams; Todd Dewey; Samir Kapadia; Vasilis Babaliaros; Vinod H Thourani; Paul Corso; Augusto D Pichard; Joseph E Bavaria; Howard C Herrmann; Jodi J Akin; William N Anderson; Duolao Wang; Stuart J Pocock Journal: N Engl J Med Date: 2011-06-05 Impact factor: 91.245
Authors: Todd M Dewey; David L Brown; Morley A Herbert; Dan Culica; Craig R Smith; Martin B Leon; Lars G Svensson; Murat Tuzcu; John G Webb; Alain Cribier; Michael J Mack Journal: Ann Thorac Surg Date: 2010-03 Impact factor: 4.330
Authors: Corrado Tamburino; Davide Capodanno; Angelo Ramondo; Anna Sonia Petronio; Federica Ettori; Gennaro Santoro; Silvio Klugmann; Francesco Bedogni; Francesco Maisano; Antonio Marzocchi; Arnaldo Poli; David Antoniucci; Massimo Napodano; Marco De Carlo; Claudia Fiorina; Gian Paolo Ussia Journal: Circulation Date: 2011-01-10 Impact factor: 29.690
Authors: Martyn Thomas; Gerhard Schymik; Thomas Walther; Dominique Himbert; Thierry Lefèvre; Hendrik Treede; Holger Eggebrecht; Paolo Rubino; Iassen Michev; Rüdiger Lange; William N Anderson; Olaf Wendler Journal: Circulation Date: 2010-06-21 Impact factor: 29.690
Authors: Lenard Conradi; Moritz Seiffert; Olaf Franzen; Stephan Baldus; Johannes Schirmer; Thomas Meinertz; Hermann Reichenspurner; Hendrik Treede Journal: Clin Res Cardiol Date: 2010-10-21 Impact factor: 5.460
Authors: Alexander Sedaghat; Jan-Malte Sinning; Mariuca Vasa-Nicotera; Alexander Ghanem; Christoph Hammerstingl; Eberhard Grube; Georg Nickenig; Nikos Werner Journal: Clin Res Cardiol Date: 2013-07-23 Impact factor: 5.460
Authors: Marcel Weber; Eva Brüggemann; Robert Schueler; Diana Momcilovic; Jan-Malte Sinning; Alexander Ghanem; Nikos Werner; Eberhard Grube; Wolfgang Schiller; Fritz Mellert; Armin Welz; Georg Nickenig; Christoph Hammerstingl Journal: Clin Res Cardiol Date: 2015-05-13 Impact factor: 5.460
Authors: Janine Biermann; Martin Horack; Philipp Kahlert; Steffen Schneider; Georg Nickenig; Ralf Zahn; Jochen Senges; Raimund Erbel; Jürgen Wasem; Till Neumann Journal: Clin Res Cardiol Date: 2015-04-21 Impact factor: 5.460
Authors: Anna Kostopoulou; Panagiotis Karyofillis; Efthimios Livanis; George Karavolias; George Theodorakis; John Paraskevaides; Vassilis Voudris Journal: Curr Treat Options Cardiovasc Med Date: 2016-02
Authors: Nicolas A Geis; Emmanuel Chorianopoulos; Klaus Kallenbach; Florian André; Sven T Pleger; Matthias Karck; Hugo A Katus; Raffi Bekeredjian Journal: Clin Res Cardiol Date: 2014-04-21 Impact factor: 5.460