Abstract 12936: Higher In-Hospital Mortality After TAVR and PCI on Same Hospitalization: A Systematic Review and Meta-Analysis

Introduction: Aortic stenosis (AS) patients admitted for elective transcatheter aortic valve replacement (TAVR) frequently present significant coronary artery disease (CAD). Despite the increasing number of TAVR procedures, it remains unclear if the strategy of performing percutaneous coronary intervention (PCI) and TAVR during the same hospitalization differs from isolated TAVR. Methods: We performed a systematic review and meta-analysis of observational studies in patients with AS and significant CAD (lesions ≥50%). The aim of the study was to compare TAVR and PCI on same hospitalization (with no regard for whether in the same procedure) to TAVR and deferred PCI. In-hospital mortality, acute kidney injury and major bleeding were our outcomes of interest. Results: We included 4 studies with 2917 patients, 665 treated with TAVR+PCI and 2252 treated with TAVR alone. TAVR+PCI was associated with higher in-hospital mortality (OR 1.66; 95% CI 1.21 - 2.27; p=0.002; Fig. 1). However, there was no difference in acute kidney injury (OR 0.59; 95% CI 0.26 - 1.32; p=0.20; Fig. 2A). Furthermore, TAVR+PCI seemed to lower the rate of major bleeding (OR 0.65; 95% CI 0.46 - 0.93; p=0.02 Fig. 2B). Conclusions: In this meta-analysis of retrospective studies, TAVR and PCI on same hospital admission was associated with higher in-hospital mortality when compared to isolated TAVR.