LB-12
Timing of Percutaneous Coronary Intervention in Conjunction with Transcatheter Aortic Valve Replacement with Balloon Expandable Valves in the United States
Presenter
Abhijeet Dhoble, MD, MPH, FSCAI, The University of Texas Health Science Center at Houston, Houston, TX
Abhijeet Dhoble, MD, MPH, FSCAI1, Talha Ahmad, MD1, Raymond G. Mckay, M.D., FSCAI2, Chad Kliger, M.D., FSCAI3, Nirat Beohar, M.D., FSCAI4, Suzanne J. Baron, M.D., FSCAI5 and James B. Hermiller, M.D., MSCAI6, (1)The University of Texas Health Science Center at Houston, Houston, TX, (2)Hartford Hospital, Hartford, CT, (3)Northwell Health Lenox Hill Hospital, New York, NY, (4)Mount Sinai Hospital, Miami Beach, FL, (5)Massachusetts General Hospital, Winchester, MA, (6)Ascension St Vincent Heart Center of Indiana, Carmel, IN
Keywords: Stable Ischemic Heart Disease (SIHD), Structural Heart Disease (SHD) and TAVI/TAVR/Aortic Valve
Background:
The optimal timing for percutaneous coronary intervention (PCI) in patients undergoing transcatheter aortic valve replacement (TAVR) is debatable.
Methods:
Leveraging the STS/ACC TVT Registry and Medicare linkage, we analyzed patients with stable coronary disease undergoing PCI and TAVR (within 90 days of each other) between 2015 and 2023 using contemporary balloon expandable bioprosthesis.
Results:
A total of 49,344 patients undergoing PCI before (84.7%), after (1.3%) or concomitantly (14%) with TAVR were included in this analysis. In a propensity-matched analysis, composite of all-cause mortality and stroke were similar in 3 groups at 3 years of follow up. However, due to small numbers of patients undergoing PCIs after the TAVR, while comparing the other two groups, event rates were significantly lower in patients undergoing PCI before TAVR as compared with concomitant PCI with TAVR at 3 years (p = 0.002).
Conclusions:
In patients with stable CAD undergoing TAVR, there is no difference in outcomes at three years amongst three groups. 
