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Review
. 2024 Jun 16;13(12):3521.
doi: 10.3390/jcm13123521.

Percutaneous Coronary Intervention before or after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis Involving 1531 Patients

Rodolfo Caminiti  1   2 , Alfonso Ielasi  1 , Giampaolo Vetta  3 , Antonio Parlavecchio  4 , Domenico Giovanni Della Rocca  3 , Dario Pellegrini  1 , Mariano Pellicano  1 , Carolina Montonati  1 , Nastasia Mancini  5 , Gabriele Carciotto  4 , Manuela Ajello  4 , Giustina Iuvara  4 , Francesco Costa  4 , Giulia Laterra  6 , Marco Barbanti  6 , Fabrizio Ceresa  7 , Francesco Patanè  7 , Antonio Micari  4 , Giampiero Vizzari  4
Affiliations
Review

Percutaneous Coronary Intervention before or after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis Involving 1531 Patients

Rodolfo Caminiti et al. J Clin Med. .

Abstract

Background: The optimal timing to perform percutaneous coronary interventions (PCIs) in patients undergoing transcatheter aortic valve replacement (TAVR) is not well established. In this meta-analysis, we aimed to compare the outcomes of patients undergoing PCI before versus after TAVR. Methods: A comprehensive literature search was performed including Medline, Embase, and Cochrane electronic databases up to 5 April 2024 for studies that compared PCI before and after TAVR reporting at least one clinical outcome of interest (PROSPERO ID: CRD42023470417). The analyzed outcomes were mortality, stroke, and myocardial infarction (MI) at follow-up. Results: A total of 3 studies involving 1531 patients (pre-TAVR PCI n = 1240; post-TAVR PCI n = 291) were included in this meta-analysis following our inclusion criteria. Mortality was higher in the pre-TAVR PCI group (OR: 2.48; 95% CI: 1.19-5.20; p = 0.02). No differences were found between PCI before and after TAVR for the risk of stroke (OR: 3.58; 95% CI: 0.70-18.15; p = 0.12) and MI (OR: 0.66; 95% CI: 0.30-1.42; p = 0.29). Conclusions: This meta-analysis showed in patients with stable CAD undergoing TAVR that PCI after TAVR is associated with lower mortality compared with PCI before TAVR.

Keywords: PCI; aortic stenosis; coronary artery disease; transcatheter aortic valve implantation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Evidence search and selection of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Figure 2
Figure 2
Forest plots comparing mortality between PCI pre- and post-TAVR. CI: confidence interval, M-H: Mantel–Haenszel, TAVR: transcatheter aortic valve replacement [10,11,12].
Figure 3
Figure 3
Forest plots comparing stroke events between PCI pre- and post-TAVR. CI: confidence interval, M-H: Mantel–Haenszel, TAVR: transcatheter aortic valve replacement [10,11,12].
Figure 4
Figure 4
Forest plots comparing myocardial infarction between PCI pre- and post-TA VR. CI: confidence interval, M-H: Mantel–Haenszel, TAVR: transcatheter aortic valve replacement [10,11,12].
Figure 5
Figure 5
Adjusted hazard ratio comparing mortality between PCI pre- and post-TAVR. CI: confidence interval, M-H: Mantel–Haenszel, TAVR: transcatheter aortic valve replacement [10,11,12].
See this image and copyright information in PMC

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