Chodór Piotr, Wilczek Krzysztof, Włoch Łukasz, Przybylski Roman, Głowacki Jan, Kukulski Tomasz, Niklewski Tomasz, Zembala Marian, Gąsior Mariusz, Kalarus Zbigniew
Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
3 Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
Postepy Kardiol Interwencyjnej. 2019;15(2):167-175. doi: 10.5114/aic.2019.84394. Epub 2019 Apr 9.
The presence of coronary artery disease (CAD) in patients who underwent transcatheter aortic valve implantation (TAVI) may increase in-hospital and long-term mortality.
To evaluate the impact of CAD in patients who underwent TAVI.
The study group consisted of the first 142 patients treated with TAVI between 26 November 2008 and 31 December 2015. The patients were divided into two groups: group I comprised 103 (72.5%) patients with CAD, and group II comprised 39 (27.5%) patients without CAD.
Group I was characterized by a significantly higher risk according to EuroSCORE - 11.2 ±2.5 vs. 9 ±2.3 in group II ( < 0.001) and Logistic EuroSCORE - 25.4 ±13.4 vs. 16.3 ±8.7 ( < 0.001). 30-day mortality was 8 (7.8%) vs. 2 (5.1%) ( = NS) and 1-year mortality was 22 (21.4%) vs. 6 (15.4%) ( = NS) in group I and II respectively. The composite endpoint evaluating the efficacy of TAVI was achieved in 82 (79.6%) vs. 31 (79.5%) ( = NS) in group I and II respectively. The composite endpoint, which involved 30-day observation, occurred in 39 (37.86%) vs. 12 (30.77%) ( = NS) and the composite endpoint, which involved 1-year evaluation of the clinical efficacy of TAVI, occurred in 48 (57.8%) vs. 13 (48.1%) ( = NS) in patients with and without CAD respectively.
The short- and mid-term outcomes of TAVI patients with CAD, despite higher risk profile, did not differ from the outcomes of treatment in patients without CAD.
接受经导管主动脉瓣植入术（TAVI）的患者中存在冠状动脉疾病（CAD）可能会增加住院和长期死亡率。
评估CAD对接受TAVI患者的影响。
研究组由2008年11月26日至2015年12月31日期间接受TAVI治疗的前142例患者组成。患者分为两组：第一组包括103例（72.5%）患有CAD的患者，第二组包括39例（27.5%）无CAD的患者。
根据欧洲心脏手术风险评估系统（EuroSCORE），第一组的风险显著更高——分别为11.2±2.5与第二组的9±2.3（P<0.001）以及逻辑欧洲心脏手术风险评估系统（Logistic EuroSCORE）——25.4±13.4与16.3±8.7（P<0.001）。第一组和第二组的30天死亡率分别为8例（7.8%）与2例（5.1%）（P=无统计学差异），1年死亡率分别为22例（21.4%）与6例（15.4%）（P=无统计学差异）。评估TAVI疗效的复合终点在第一组和第二组中分别有82例（79.6%）与31例（79.5%）实现（P=无统计学差异）。涉及30天观察的复合终点在有CAD和无CAD的患者中分别有39例（37.86%）与12例（30.77%）出现（P=无统计学差异），而涉及TAVI临床疗效1年评估的复合终点在有CAD和无CAD的患者中分别有48例（57.8%）与13例（48.1%）出现（P=无统计学差异）。
尽管CAD患者风险更高，但TAVI患者的短期和中期结果与无CAD患者的治疗结果并无差异。
