ACC: Percutaneous Coronary Intervention Can Be Delayed Until After TAVR in Some Patients

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By Lori Solomon HealthDay Reporter

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via HealthDay

FRIDAY, April 3, 2026 -- Older patients with coronary artery disease scheduled for transcatheter aortic valve replacement (TAVR) have comparable outcomes regardless of whether they undergo percutaneous coronary intervention (PCI) before TAVR, according to a study presented at the annual meeting of the American College of Cardiology, held from March 28 to 30 in New Orleans.

Ronak Delewi, M.D. Ph.D., from University Medical Center Utrecht in the Netherlands, and colleagues examined the need for routine revascularization of significant coronary artery disease (CAD) in patients undergoing TAVR. Analysis included 466 patients with concomitant CAD planning to undergo TAVR who were randomly assigned to either PCI before their TAVR procedure (reference) or no PCI (index).

The researchers found that the primary end point of a composite of death from any cause, heart attack, stroke, or moderate-to-severe bleeding at 12 months occurred in 25.8 percent of those who underwent PCI before TAVR and 24.1 percent of those who deferred PCI, meeting the trial's prespecified threshold for noninferiority. Neither approach showed superiority. The two groups showed a significant difference in the rate of major bleeding (14.8 percent with PCI before TAVR versus 6.2 percent with deferred PCI). This increase in bleeding was likely due to the dual antiplatelet therapy prescribed after PCI, as most bleeds occurred around the time of the TAVR procedure, although there was no excess mortality associated with major bleeding. Among patients in the deferred PCI group, about 10 percent of patients eventually underwent PCI due to continuing or worsening symptoms following TAVR.

"For elderly TAVR patients with concomitant coronary artery disease, I think it's safe to first do TAVR and see if patients will still have complaints about chest pain or tightness," Michiel Voskuil, M.D., Ph.D., also from University Medical Center Utrecht, said in a statement. "We can wait and, if they still have complaints afterward, only then do PCI."

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

Source: HealthDay

Posted : 2026-04-04 08:52

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