Clinical outcomes of percutaneous coronary interventions after transcatheter aortic valve replacement.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pivato Carlo A, Cozzi Ottavia, Fontana Nicole, Ieva Francesca, Condorelli Gianluigi, Godino Cosmo, Reimers Bernhard, Nakase Masaaki, Hug Karsten, Rheude Tobias, Munoz-Garcia Antonio J, Jimenez Diaz Victor Alfonso, Ielasi Alfonso, Barbanti Marco, Biasco Luigi, Mylotte Darren, Leoncini Massimo, de la Torre Hernandez Jose M, Quadri Giorgio, Varbella Ferdinando, Anzuini Angelo, Lopez Diego, Garot Philippe, Brouwer Jorn, Mangieri Antonio, Regazzoli Damiano, Testa Luca, Sanz Sanchez Jorge, Tomii Daijiro, Chieffo Alaide, Joner Michael, Sardella Gennaro, Cerrato Enrico, Nombela-Franco Luis, Pilgrim Thomas, Stefanini Giulio
Аннотация
METHODS AND RESULTS: Consecutive PCI patients with prior TAVR were compared to patients without prior TAVR between 2008 and 2023. The Kaplan-Meier method was used to estimate the 1-year incidence of major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death or myocardial infarction. An entropy balance approach was implemented to adjust for imbalances in patient and procedural characteristics. Adjusted hazard ratios (HRs) were estimated using weighted Cox regression models. Comparing 420 PCI patients with prior TAVR (mean age 80.8 years, 37.1% women) to 1197 without (mean age 70.4 years, 24.6% women), 1-year MACE was higher in the prior TAVR group (8.7 vs. 3.7%; unadjusted HR 2.35, 95% CI 1.49-3.69; P < 0.001). After adjustment for clinical and procedural characteristics, prior TAVR remained associated with an increased risk of MACE (adjusted HR 2.36, 95% CI 1.08-5.16; P = 0.032). This was primarily driven by higher cardiovascular death (adjusted HR 3.12, 95% CI 1.10-8.79, P = 0.032), while the association with myocardial infarction was attenuated post-adjustment and no longer statistically significant.
CONCLUSION: Patients undergoing PCI after TAVR experience a higher incidence of MACE compared to those undergoing PCI without prior TAVR, underscoring the importance of accurate patient selection before performing PCI in patients with chronic coronary syndrome and history of TAVR.