Miyahara Daisuke, Izumo Masaki, Sato Yukio, Shoji Tatsuro, Yamaga Mitsuki, Sekiguchi Masahiro, Tanaka Tetsu, Kobayashi Yoshikuni, Kai Takahiko, Okuno Taishi, Kuwata Shingo, Koga Masashi, Tanabe Yasuhiro, Akashi Yoshihiro J
Department of Cardiology, St. Marianna University School of Medicine, 2-16-1, Sugao,Miyamae-ku, Kawasaki, 216-8511, Japan.
Cardiovasc Interv Ther. 2025 Apr;40(2):352-361. doi: 10.1007/s12928-025-01094-w. Epub 2025 Feb 3.
Calcium channel blockers (CCBs) are commonly used to treat coronary artery disease (CAD). The effects of the use of CCBs on the prognosis of patients with aortic stenosis (AS) after transcatheter aortic valve intervention (TAVI) has not been explored. This study elucidated the effects of the use of CCBs on clinical outcomes of patients who underwent TAVI for severe AS. This retrospective observational study included 993 consecutive patients who underwent TAVI for severe AS between January 2017 and July 2023. All patients were followed up for all-cause mortality and hospitalisation for heart failure. Composite endpoints between patients with and without CCBs at discharge were compared using propensity score matching (PSM). CCBs were administered to 590 (59.4%) patients following TAVI. Over a median follow-up period of 719 (335-1,120) days, the composite endpoint occurred in 269 patients. After PSM, there was no significant difference in the composite endpoint between the two groups (hazard ratio = 0.879; p = 0.409). Subgroup analysis revealed that the use of CCBs was associated with a better prognosis in the CAD subgroup (p for interaction = 0.002). This study does not suggest that the use of CCBs is associated with worse clinical outcomes in patients after TAVI for severe AS. Additionally, the use of CCBs may lead to a better prognosis in patients with CAD.
钙通道阻滞剂（CCBs）常用于治疗冠状动脉疾病（CAD）。CCBs对经导管主动脉瓣介入治疗（TAVI）后主动脉瓣狭窄（AS）患者预后的影响尚未得到研究。本研究阐明了CCBs对重度AS患者接受TAVI后临床结局的影响。这项回顾性观察性研究纳入了2017年1月至2023年7月期间连续993例接受重度AS的TAVI患者。所有患者均随访全因死亡率和因心力衰竭住院情况。使用倾向评分匹配（PSM）比较出院时使用和未使用CCBs患者之间的复合终点。590例（59.4%）患者在TAVI后接受了CCBs治疗。在中位随访期719（335 - 1120）天内，269例患者出现复合终点。PSM后，两组之间的复合终点无显著差异（风险比 = 0.879；p = 0.409）。亚组分析显示，在CAD亚组中，使用CCBs与更好的预后相关（交互作用p = 0.002）。本研究并不表明在重度AS患者接受TAVI后使用CCBs与更差的临床结局相关。此外，使用CCBs可能会使CAD患者的预后更好。
