PDF(Pubmed)
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.
摘要：
背景：在接受经导管主动脉瓣置换术（TAVR）的患者中进行经皮冠状动脉介入治疗（PCI）的最佳时机尚未确定。在这个荟萃分析中，我们的目的是比较接受PCI术前与TAVR术后患者的结局.方法：进行了全面的文献检索，包括Medline，Embase,和截至2024年4月5日的Cochrane电子数据库，用于比较TAVR报告至少一项临床结果的PCI前后的研究(PROSPEROID:CRD42023470417)。分析的结果是死亡率，中风,随访时心肌梗死（MI）。结果：根据我们的纳入标准，共有3项研究纳入了1531例患者（TAVRPCI前n=1240；TAVRPCI后n=291）。TAVR前PCI组的死亡率更高（OR：2.48；95％CI：1.19-5.20；p=0.02）。TAVR前后PCI的卒中风险(OR:3.58;95%CI:0.70-18.15;p=0.12)和MI(OR:0.66;95%CI:0.30-1.42;p=0.29)无差异。结论：这项荟萃分析显示，在接受TAVR的稳定型CAD患者中，TAVR后PCI与TAVR前PCI相比，死亡率较低。
