Does coronary artery disease has any impact on clinical outcomes after transcatheter aortic valve implantation? A brazilian single center experience.

Background: Transcatheter aortic valve implantation (TAVI) has become a treatment option for high surgical risk (HSR) patients with severe aortic valve stenosis (SAE), but the impact of coronary artery disease (CAD) in this context is still unknown.

Objective: To evaluate the impact of CAD assessed by the SYNTAX score (Ss) on outcomes of patients with SAE undergoing TAVI.

Methods: retrospective and prospective brazilian single-center study of 135 consecutive patients with HSR undergoing TAVI from July 2009 to April 2015. CAD was assessed by Ss and the clinical events were analyzed up to 2 years. Statistical analysis: χ2 or Fisher exact tests for categorical data and ANOVA of Kruskal-Wallis and Dunn multiple comparison tests for numerical data. Cox and Poisson regressions to identify predictors of clinical events, and Multivariate Cox regression to identify clinical predictors. The significance criterion was 5%.

Results: 96.3% (n=130) of self-expandable prosthesis and 3.7% (n=5) of balloon expandable. The coort was divided into 3 groups: patients without CAD (n = 60); with Ss ≤22 (n =59) and with Ss>22 (n=16). There were no statistically significant differences among the 3 groups for clinical and cardiovascular outcomes, and neither on cardiovascular and global mortality within 2 years. Pulmonary hypertension was the only factor with negative outcomes at all times of evolution, including cardiovascular mortality at 1 year (p = 0.047, HR:1.02) and 2 years (p = 0.013, HR:1.48).

Conclusion: CAD showed no impact on outcomes of up 2 years after TAVI.