Next Article in Journal
Neutralizing Antibody Production in Asymptomatic and Mild COVID-19 Patients, in Comparison with Pneumonic COVID-19 Patients
Previous Article in Journal
Assessment of the Most Impactful Combination of Factors Associated with Nocturia and to Define Nocturnal Polyuria by Multivariate Modelling
Open AccessArticle

Impact of Incomplete Coronary Revascularization on Late Ischemic and Bleeding Events after Transcatheter Aortic Valve Replacement

1
Pôle d’Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67000 Strasbourg, France
2
Department of Biostatistics, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 67000 Strasbourg, France
3
Vietnam National Heart Institute, Bach Mai Hospital, Hanoi 100000, Vietnam
4
UMR INSERM 1260 Regenerative Nanomedicine, Université de Strasbourg, 67000 Strasbourg, France
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2267; https://doi.org/10.3390/jcm9072267
Received: 16 May 2020 / Revised: 16 June 2020 / Accepted: 14 July 2020 / Published: 16 July 2020
(This article belongs to the Section Cardiology)
Background: The impact of coronary artery disease (CAD) and revascularization by percutaneous coronary intervention (PCI) on prognosis in patients undergoing transcatheter aortic valve replacement (TAVR) remain debated. A dismal prognosis in patients undergoing PCI has been associated with elevated baseline SYNTAX score (bSS) and residual SYNTAX score (rSS). The objective was to investigate whether the degree of bSS and rSS impacted ischemic and bleeding events after TAVR. Methods: bSS and rSS were calculated in 311 patients admitted for TAVR. The primary outcome was the occurrence of major adverse cardiac events (MACE), a composite endpoint of myocardial infarction, stroke, cardiovascular death, or rehospitalization for heart failure. The occurrence of late major/life-threatening bleeding complications (MLBCs) and each primary endpoint individually were the secondary endpoints. Results: bSS > 22 was associated with higher occurrence of MACE (p = 0.013). rSS > 8 and bSS > 22 had no impact on overall cardiovascular mortality. rSS > 8 and bSS > 22 were associated with higher rates of myocardial infarction (p = 0.001 and p = 0.004) and late occurrence of MLBCs. Multivariate analysis showed that bSS > 22 (sHR 2.48) and rSS > 8 (sHR 2.35) remained predictors of MLBCs but not of myocardial infarction. Conclusions: Incomplete coronary revascularization and CAD burden did not impact overall and cardiac mortality but constitute predictors of late MLBCs in TAVR patients. View Full-Text
Keywords: transcatheter aortic valve replacement; baseline SYNTAX score; residual SYNTAX score; bleeding transcatheter aortic valve replacement; baseline SYNTAX score; residual SYNTAX score; bleeding
Show Figures

Figure 1

MDPI and ACS Style

Carmona, A.; Marchandot, B.; Severac, F.; Kibler, M.; Trimaille, A.; Heger, J.; Peillex, M.; Matsushita, K.; Ristorto, J.; Hoang, V.A.; Hess, S.; Jesel, L.; Ohlmann, P.; Morel, O. Impact of Incomplete Coronary Revascularization on Late Ischemic and Bleeding Events after Transcatheter Aortic Valve Replacement. J. Clin. Med. 2020, 9, 2267.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop