# Pre- versus concomitante PCI bij TAVR-levering geen verschil op in 90-dagen-uitkomsten bij kwetsbare patiënten

*geplaatst 2026-10-18 · Algemeen · The American journal of cardiology · doi 10.1016/j.amjcard.2026.10.011 · https://hartvaat.nl/2026/10/10/pre-versus-concomitante-pci-bij-tavr-levering-geen-verschil-op-in-90-dagen-uitko/*

Een retrospectieve cohortstudie met propensity score-matching onderzocht of pre-TAVR PCI of concomitante PCI beter scoort bij kwetsbare patiënten met hoge-risico kenmerken. Na matching waren er geen significante verschillen in de 90-dagen-composite (sterfte, AKI, bloedingen, ACS, beroerte) tussen beide strategieën (27,4% versus 29,4%; RR 1,07; p=0,56), noch in sterfte op korte of lange termijn. Deze bevindingen ondersteunen een individueel afgestemde aanpak voor het moment van PCI bij patiënten die een TAVR ondergaan.

## English: A Propensity-Matched Analysis of Pre Versus Concomitant Percutaneous Coronary Intervention in Patients Undergoing Transcatheter Aortic Valve Replacement With Frailty-Related High-Risk Features.

A propensity-matched retrospective cohort study compared pre-TAVR versus concomitant PCI in frail, high-risk patients undergoing transcatheter aortic valve replacement. No significant differences were observed between the two timing strategies in a 90-day composite of mortality, acute kidney injury, bleeding, ACS, and stroke (27.4% vs 29.4%; RR 1.07; p=0.56), nor in all-cause mortality at 30 days or 1 year. These findings suggest that PCI timing can be individualized based on patient-specific factors rather than adhering to a fixed protocol.

## Abstract (original, from the publication)

BACKGROUND: Percutaneous coronary intervention (PCI) is frequently performed in patients undergoing transcatheter aortic valve replacement (TAVR); however, the optimal timing of PCI remains uncertain, particularly in patients with frailty-related high-risk features. Evidence comparing pre-TAVR versus concomitant PCI strategies in this vulnerable population is limited. METHODS: We conducted a retrospective cohort study using the TriNetX Research Network to identify patients with frailty-related high-risk features undergoing TAVR with either pre-TAVR PCI (3 months to 2 weeks before TAVR) or concomitant PCI (same day as TAVR). Propensity score matching (1:1) was performed using demographics, comorbidities, frailty-related features, and antiplatelet and anticoagulant therapy. The primary outcome was a 90-day composite including all-cause mortality, acute kidney injury, bleeding requiring transfusion, gastrointestinal bleeding, intracranial hemorrhage, acute coronary syndrome, and ischemic stroke. Secondary outcomes included the composite outcome at 30 days and 1 year, as well as individual components. RESULTS: After propensity score matching, 361 patients were included in each group with adequate baseline balance. The primary 90-day composite outcome occurred in 27.4% of patients undergoing pre-TAVR PCI and 29.4% undergoing concomitant PCI (RR 1.07, 95% CI 0.85-1.35; p=0.56). At 30 days, the composite outcome occurred in 21.9% and 24.4% of patients, respectively (RR 1.11, 95% CI 0.85-1.45; p=0.43). At 1 year, the composite outcome occurred in 37.1% of the pre-TAVR PCI group and 38.5% of the concomitant PCI group (RR 1.04, 95% CI 0.86-1.25; p=0.70). No significant differences were observed in all-cause mortality at any time point. CONCLUSIONS: Among patients with frailty-related high-risk features undergoing TAVR, pre-TAVR PCI and concomitant PCI were associated with similar short- and longer-term clinical outcomes. No significant differences were observed in the 90-day composite outcome or all-cause mortality. These findings support an individualized approach to PCI timing in frail, high-risk patients.

Auteurs: Avery Love, Duc-Hieu Bui, Shahman Shahab, Avinav Sanjel, Chandler O'Leary, Hani Jneid, Aiham Albaeni

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Bron: The American journal of cardiology, https://doi.org/10.1016/j.amjcard.2026.10.011. Bijgewerkt 2026-10-12T01:09:24Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.