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Abstract：
Background/Objectives: To date, data regarding the characteristics and management of obstructive, stable coronary artery disease (CAD) encountered in patients undergoing transcatheter aortic valve implantation (TAVI) are sparse. The aim of the study was to analyze granular details, treatment, and outcomes of patients undergoing TAVI with obstructive, stable CAD from real-world practice. Methods: REVASC-TAVI (Management of myocardial REVASCularization in patients undergoing Transcatheter Aortic Valve Implantation with coronary artery disease) is an investigator-initiated, multicenter registry, which collected data from patients undergoing TAVI with obstructive stable CAD found during the pre-TAVI work-up. Results: A total of 2025 patients from 30 centers worldwide with complete follow-up were included in the registry. Most patients had single-vessel CAD (56.1%). An involvement of proximal coronary tracts was detected in 62.5% of cases, with 12.0% of patients having CAD in left main (LM). Most patients received percutaneous coronary intervention (PCI) (n = 1617, 79.9%), especially those with proximal CAD (90.4%). At 2 years, the rates of all-cause death [Kaplan-Meier (KM) estimates 20.1% vs. 18.8%, plog-rank = 0.86] and of the composite of all-cause death, stroke, myocardial infarction, and rehospitalization for heart failure (KM estimates 29.7% vs. 27.5%, plog-rank = 0.82) did not differ between patients undergoing PCI and those who were not. Conclusions: Patients undergoing TAVI with obstructive CAD more commonly had a single-vessel disease and an involvement of proximal coronary tracts. They were commonly treated with PCI, with similar outcomes compared to those treated conservatively.
摘要：
背景/目标：迄今为止，有关阻塞性疾病的特征和管理的数据，在接受经导管主动脉瓣植入术(TAVI)的患者中遇到的稳定型冠状动脉疾病(CAD)很少.这项研究的目的是分析颗粒细节，治疗,以及接受TAVI的患者的结果，从现实世界的实践稳定的CAD。方法：REVASC-TAVI（冠心病经导管主动脉瓣植入术患者的心肌再血管化管理）是研究者发起的，多中心注册表，收集了在TAVI前检查期间发现的患有阻塞性稳定型CAD的TAVI患者的数据。结果：共有来自全球30个中心的2025名患者接受了完整的随访。大多数患者有单血管CAD（56.1%）。在62.5％的病例中检测到近端冠状动脉受累，12.0%的患者患有左主干(LM)CAD。大多数患者接受经皮冠状动脉介入治疗（PCI）（n=1617，79.9％），尤其是近端CAD患者（90.4%）。在2年,全因死亡率[Kaplan-Meier(KM)估计20.1%与18.8%,plog-rank=0.86]和全因死亡的复合物，中风,心肌梗塞,和心力衰竭的再住院(KM估计29.7%与27.5%,plog-rank=0.82）在接受PCI的患者和未接受PCI的患者之间没有差异。结论：接受TAVI合并阻塞性CAD的患者更常见于单支血管疾病和近端冠状动脉受累。他们通常接受PCI治疗，与保守治疗的结果相似。
