Coronary Revascularization in the Era of TAVR: Timing, Strategy, and Outcomes.
Background: Coronary artery disease (CAD) is prevalent among patients undergoing transcatheter aortic valve replacement (TAVR), complicating clinical decision-making regarding optimal timing of percutaneous coronary intervention (PCI). Despite widespread clinical experience, there is ongoing controv...
| Publicado en: | Clinical Medicine Insights: Cardiology Vol. 19; pp. 1 - 11 |
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| Autores principales: | , , |
| Formato: | algorithm review tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
12/1/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189855771&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189855771 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795468 B3KL jtl: Clinical Medicine Insights: Cardiology issn: 11795468 maglogo: Y pubinfo: dt: 12/1/2025 vid: 19 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 189855771 189855771 189855771 10.1177/11795468251395832 189855771 ppf: 1 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Coronary Revascularization in the Era of TAVR: Timing, Strategy, and Outcomes. aug: au: Love, Avery O'Leary, Chandler Shahab, Shahman affil: The University of Texas Medical Branch, Galveston, USA sug: subj: Coronary Arteriosclerosis Therapy Percutaneous Coronary Intervention Transcatheter Aortic Valve Implantation Uncertainty Treatment Outcomes Time Factors Patient Centered Care Practice Guidelines Practice Patterns Aorta, Thoracic Physiology Aortic Valve Physiology Frailty Syndrome Comorbidity Decision Making Hemorrhage Risk Factors Diffusion of Innovation Risk Assessment ab: Background: Coronary artery disease (CAD) is prevalent among patients undergoing transcatheter aortic valve replacement (TAVR), complicating clinical decision-making regarding optimal timing of percutaneous coronary intervention (PCI). Despite widespread clinical experience, there is ongoing controversy and limited consensus regarding when PCI, before, during, or after TAVR, offers the best risk-benefit balance. Objective: To synthesize and critically evaluate the current evidence on different PCI timing strategies in patients undergoing TAVR and to identify areas of uncertainty and clinical complexity. Review: Randomized trials, including ACTIVATION and NOTION-3, have yielded mixed findings, highlighting a modest reduction in ischemic events with pre-TAVR PCI but increased procedural bleeding risks. Observational registries (REVASC-TAVI and the National Readmissions Database) have similarly shown that pre- and peri-TAVR PCI strategies carry heightened risks of complications without clear long-term mortality benefits. Recent meta-analyses reinforce these findings, indicating that no PCI timing strategy conclusively outperforms others in reducing long-term mortality. Key considerations such as anatomical complexity, frailty, bleeding risk, and valve type significantly influence optimal PCI timing. Conclusion: Current evidence supports a personalized, patient-centered approach to PCI timing in TAVR candidates, emphasizing careful consideration of individual anatomical and clinical factors rather than a standardized timing protocol. Further research exploring advanced risk stratification, imaging modalities, and long-term clinical outcomes is essential to refine current guidelines and practice. pubtype: Academic Journal doctype: algorithm review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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