Complete Versus Incomplete Revascularization in Patients With Severe Aortic Stenosis Undergoing Complex, High-Risk PCI: Insights From the ASCoP Registry.
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Tartaglia Francesco, Mangieri Antonio, Munafò Andrea R, Regazzoli Damiano, Esposito Giuseppe, Soriano Francesco, Arslani Ketina, Brunner Stephanie, Verhemel Sarah, Buono Andrea, Squillace Mattia, Díez Gil José Luis, Scotti Andrea, Mandurino-Mirizzi Alessandro, Bauer David, Codner Pablo, Piayda Kerstin, Porto Italo, Nava Stefano, Maurina Matteo, Gitto Mauro, Sievert Horst, Kornowski Ran, Toušek Petr, Mussardo Marco, Stefanini Giulio, Latib Azeem, Sanz Sanchez Jorge, Maffeo Diego, Bedogni Francesco, Reimers Bernhard, Van Mieghem Nicholas, Saia Francesco, Toggweiler Stefan, Oreglia Jacopo A, De Backer Ole, Montalto Claudio
Аннотация
METHODS: We analyzed 550 patients who underwent CHIP and transfemoral TAVI between 2013 and 2023 at 14 international centers. Patients were stratified by completeness of revascularization. The primary endpoint was a composite of all-cause death and unplanned cardiovascular (CV) hospitalization at 1 year.
RESULTS: CR was achieved in 299 patients (54.4%). Patients with IR more frequently had three-vessel disease, bifurcation lesions, left main disease, and need for mechanical support. Balloon-expandable valves were more frequently implanted in the CR cohort. Short-term outcomes were similar in the two groups. At 1 year, the incidence of the primary endpoint did not differ significantly between CR and IR groups (20.1 vs. 27.3%, hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.49-1.07). CV rehospitalizations were significantly reduced in the CR group (14.8 vs. 22.8%, HR 0.61, 95% CI 0.38-0.97) even after multivariable adjustment and excluding hospitalizations for repeat revascularization.
CONCLUSIONS: In patients undergoing CHIP and TAVI, CR was associated with a reduction in CV hospitalizations. Further studies are needed to confirm this finding.