University of Oulu

Marco Barbanti, Sergio Buccheri, Davide Capodanno, Paola D'Errigo, Marco Ranucci, Stefano Rosato, Gennaro Santoro, Danilo Fusco, Corrado Tamburino, Fausto Biancari, Fulvia Seccareccia, Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease: A comparative analysis from the Italian OBSERVANT study, International Journal of Cardiology, Volume 270, 2018, Pages 102-106, ISSN 0167-5273, https://doi.org/10.1016/j.ijcard.2018.06.011

Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease : a comparative analysis from the Italian OBSERVANT study

Saved in:
Author: Barbanti, Marco1; Buccheri, Sergio1; Capodanno, Davide1;
Organizations: 1Division of Cardiology, Ferrarotto Hospital, University of Catania, Italy
2National Centre for Global Health - Istituto Superiore di Sanità, Rome, Italy
3Department of Cardiothoracic and Vascular Anesthesia and ICU - IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
4Division of Cardiology, Careggi Hospital, Florence, Italy
5Department of Epidemiology of Lazio Regional Health Service, Rome, Italy
6Department of Surgery, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019102134053
Language: English
Published: Elsevier, 2018
Publish Date: 2019-10-21
Description:

Abstract

Background: To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG).

Methods: Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session.

Results: After propensity-score matching, a total of 472 patients (236 per group) were identified. Among TAVI patients, PCI was performed prior to the procedure in 217 patients (92.0%), whereas concomitant TAVI and PCI were performed in 19 patients (8.0%). At 3-year, there was no difference in survival between the two groups (KM estimate of freedom from death for SAVR and TAVI patients of 0.742 and 0.650, respectively; log-rank p-value of 0.105). The rate of MACCE was comparable between the two groups (KM estimate of freedom from MACCE for SAVR and TAVI patients of 0.683 and 0.582, respectively; log-rank p-value of 0.115).

Conclusions: In patients with associated severe AS and CAD, percutaneous treatment (TAVR and staged or concomitant PCI) was comparable to surgical treatment (SAVR and concomitant CABG) with respect to the early and mid-term risk of death from any cause, myocardial infarction, stroke and unplanned revascularization.

see all

Series: International journal of cardiology
ISSN: 0167-5273
ISSN-E: 0167-5273
ISSN-L: 0167-5273
Volume: 270
Pages: 102 - 106
DOI: 10.1016/j.ijcard.2018.06.011
OADOI: https://oadoi.org/10.1016/j.ijcard.2018.06.011
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
3121 General medicine, internal medicine and other clinical medicine
Subjects:
PCI
Copyright information: © 2018 Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.
  https://creativecommons.org/licenses/by-nc-nd/4.0/