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Text
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URL Address
<a href="http://doi.org/10.1002/ccd.27894" target="_blank" rel="noreferrer noopener">http://doi.org/10.1002/ccd.27894</a>
Pages
545-552
Issue
3
Volume
93
ISSN
1522-726X 1522-1946
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Update Year & Number
June2020SubmittedList
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Internal Medicine
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Impact of residual coronary atherosclerosis on transfemoral transcatheter aortic valve replacement.
Publisher
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Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Date
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2019
2019-02-15
Subject
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Female; Humans; Male; Aged; Retrospective Studies; Treatment Outcome; Risk Factors; Time Factors; Aged 80 and over; Patient Readmission; Risk Assessment; Cause of Death; Coronary Artery Disease/diagnostic imaging/mortality/therapy; AVD - aortic valve disease; CAD - coronary artery disease; Catheterization Peripheral/adverse effects/mortality; Femoral Artery; PCI - percutaneous coronary intervention (PCI); Percutaneous Coronary Intervention/adverse effects/mortality; percutaneous intervention; Transcatheter Aortic Valve Replacement/adverse effects/mortality; Aortic Valve Stenosis/diagnostic imaging/mortality/physiopathology/surgery; Aortic Valve/diagnostic imaging/physiopathology/surgery; Punctures
Creator
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Li Jun; Patel SM; Nadeem F; Thakker P; Al-Kindi SG; Thomas R; Makani A; Hornick JM; Patel T; Lipinski J; Ichibori Y; Davis A; Markowitz AH; Bezerra HG; Simon DI; Costa MA; Kalra A; Attizzani GF
Description
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OBJECTIVES: This study reports on the clinical effects of complete vs incompletely revascularized coronary artery disease on transcatheter aortic valve replacement (TAVR). BACKGROUND: There is a high prevalence of active coronary artery disease (CAD) in patients undergoing TAVR but preemptive revascularization remains controversial. METHODS: Patients were categorized into three cohorts: complete revascularization (CR), incomplete revascularization of a major epicardial artery (IR Major), and incomplete revascularization of a minor epicardial artery only (IR Minor). When feasible, SYNTAX scoring was performed for exploratory analysis. Analyses were performed using Cox proportional hazard models and Kaplan-Meier method. RESULTS: A total of 323 patients with active CAD were included. Adjusted outcomes showed that patients with IR Major had increased incidence of acute myocardial infarction (AMI) or revascularization compared with those in the CR cohort (HR 3.72, P = 0.048). No difference was noted in all-cause mortality or all-cause readmission rates. Exploratory secondary analysis with residual SYNTAX scores showed a significant interaction between disease burden and AMI/revascularization, as well as all-cause readmission. All-cause mortality remained unaffected based on residual SYNTAX scores. CONCLUSIONS: This is a retrospective single-center study reporting on pre-TAVR revascularization outcomes in patients with active CAD. In this analysis, we found that patients undergoing TAVR benefited from achieving complete revascularization to abate future incidence of AMI/revascularization. Despite this finding, all-cause mortality remained unaffected. Future efforts should focus on the role of functional assessment of the coronaries, as well as the long-term effects of complete revascularization in a larger patient cohort.
Identifier
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<a href="http://doi.org/10.1002/ccd.27894" target="_blank" rel="noreferrer noopener">10.1002/ccd.27894</a>
PMID: 30312990
Rights
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© 2018 Wiley Periodicals, Inc.
Format
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journalArticle
2019
Aged
Aged 80 and over
Al-Kindi SG
Aortic Valve Stenosis/diagnostic imaging/mortality/physiopathology/surgery
Aortic Valve/diagnostic imaging/physiopathology/surgery
Attizzani GF
AVD - aortic valve disease
Bezerra HG
CAD - coronary artery disease
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Catheterization Peripheral/adverse effects/mortality
Cause of Death
Cleveland Clinic Akron General Hospital
Coronary Artery Disease/diagnostic imaging/mortality/therapy
Costa MA
Davis A
Department of Internal Medicine
Female
Femoral Artery
Hornick JM
Humans
Ichibori Y
journalArticle
June2020SubmittedList
Kalra A
Li Jun
Lipinski J
Makani A
Male
Markowitz AH
Nadeem F
NEOMED College of Medicine
Patel SM
Patel T
Patient Readmission
PCI - percutaneous coronary intervention (PCI)
Percutaneous Coronary Intervention/adverse effects/mortality
percutaneous intervention
Punctures
Retrospective Studies
Risk Assessment
Risk Factors
Simon DI
Thakker P
Thomas R
Time Factors
Transcatheter Aortic Valve Replacement/adverse effects/mortality
Treatment Outcome