title: Impact of coronary artery disease in elderly patients undergoing transcatheter aortic valve implantation: insight from the Italian CoreValve Registry.
abstract: BACKGROUND
  Coronary artery disease (CAD) commonly coexists with degenerative aortic stenosis. The impact of CAD in patients undergoing transcatheter aortic valve implantation (TAVI) raises concerns due to the lack of comprehensive and consistent data on this topic. We sought to evaluate the impact of CAD on clinical outcomes in patients undergoing TAVI.
  
  
  METHODS
  Consecutive patients(N=663) who underwent TAVI with the 18-French CoreValve ReValving System (CRS) (Medtronic Inc, MN USA) from June 2007 through December 2009 at 14 institutions across Italy were included in this prospective web-based registry. Four patients were excluded from the analysis due to failure to successfully release the prosthesis inside the native aortic valve. Previous percutaneous or surgical myocardial revascularizations were used to identify the existence of concomitant CAD (N=251; 38%). The primary endpoint was the incidence of Major Adverse Cerebrovascular and Cardiac Events (MACCE) and all-cause death in CAD and no-CAD groups.
  
  
  RESULTS
  Patients with CAD were no more likely to develop MACCE within 12-months of the procedure than those who did not (CAD group vs no-CAD group, 15.7% vs 18.3%; adjusted hazard ratio [HR] 0.76; 95% confidence interval [CI] 0.42 to 1.36; p=0.353). The 12-month mortality was 14.5% and 15.9% in CAD group and no-CAD group, respectively (adjusted HR 0.74; 95% CI 0.40 to 1.36; p=0.331).
  
  
  CONCLUSIONS
  Coexisting CAD does not impact procedural outcomes and mid-term incidence of MACCE and survival in elderly patients undergoing TAVI with CRS prosthesis.
authors.affiliation: Ferrarotto Hospital, Catania, Italy. gpussia@hotmail.com
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ussia
authors.forename: Marco
authors.initials: M
authors.lastname: Barbanti
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
authors.forename: Anna Sonia
authors.initials: AS
authors.lastname: Petronio
authors.forename: Federica
authors.initials: F
authors.lastname: Ettori
authors.forename: Angelo
authors.initials: A
authors.lastname: Ramondo
authors.forename: Gennaro
authors.initials: G
authors.lastname: Santoro
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
authors.forename: Francesco
authors.initials: F
authors.lastname: Bedogni
authors.forename: David
authors.initials: D
authors.lastname: Antoniucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Poli
authors.forename: Marco
authors.initials: M
authors.lastname: De Carlo
authors.forename: Claudia
authors.initials: C
authors.lastname: Fiorina
authors.forename: Federico
authors.initials: F
authors.lastname: De Marco
authors.forename: Massimo
authors.initials: M
authors.lastname: Napodano
authors.forename: Roberto
authors.initials: R
authors.lastname: Violini
authors.forename: Alessandro Santo
authors.initials: AS
authors.lastname: Bortone
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000639:trends*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000639:trends*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome