EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Coronary artery disease management in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis of randomised controlled trials
By Bujak K, Giacoppo D, Laudani C and 8 others.
Abstract
Background
The optimal management of coronary artery disease in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) remains uncertain.
Aims
We aimed to compare clinical outcomes between routine coronary revascularisation and conservative management in patients undergoing TAVI and to assess the relative effectiveness of individual revascularisation strategies by performing a meta-analysis of randomised trials.
Methods
We conducted a pairwise meta-analysis comparing percutaneous coronary intervention (PCI) with conservative treatment and a network meta-analysis comparing the relative effectiveness of individual strategies, including angiography-guided and physiology-guided PCI. The primary outcome was a study-defined composite endpoint of major adverse cardiovascular events (MACE). Secondary endpoints included the individual outcomes of all-cause death, cardiovascular death, myocardial infarction, stroke, unplanned revascularisation, and major bleeding.