Performing PCI and TAVR together may improve in-hospital outcomes, long-term survival
When patients require percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR), performing both procedures at the same time may have short- and long-term benefits. That is according to a new analysis published in Cardiovascular Revascularization Medicine.[1]
“As the indication for TAVR expands to younger and lower-risk populations, clinical decision-making must adapt to the increasingly common co-presentation of significant coronary artery disease (CAD),” wrote first author Vlasis Ninios, MD, an interventional cardiologist with Interbalkan European Medical Center, and colleagues. “It is estimated that over 50% of patients undergoing TAVR exhibit angiographically significant CAD.”
Ninios et al. tracked data from more than 200 patients who presented with severe aortic stenosis and significant CAD and then underwent TAVR at a single facility from 2019 to 2024. Patients either underwent PCI seven to 45 days prior to TAVR or underwent simultaneous PCI and TAVR.
To make the comparison more effective, the group used propensity matching to focus on two pairs of 50 patients: one group that underwent PCI first (PCI first) and another group that underwent both procedures during a single session (PCI/TAVR).
In-hospital mortality was comparable between the two groups—4% for PCI first patients and 2% for PCI/TAVR patients. Major vascular complications did happen more often among PCI first patients, but the difference was not significant.
After three years, meanwhile, the PCI/TAVR patients had a restricted mean survival time (RMST) that was 68 days longer than the PCI first patients. PCI/TAVR patients were also linked to fewer bleeding events and blood transfusions.
“No significant differences were observed between the two groups regarding the incidence of periprocedural stroke, myocardial infarction or acute kidney injury, in either the total or matched populations,” the authors added.
Overall, the group concluded that these findings support the “safety and procedural viability” of performing simultaneous PCI and TAVR. Additional research is still needed, however, to confirm how the timing of PCI impacts long-term patient outcomes.
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.