How Common Is ACS After Transcatheter Aortic-Valve Replacement?

Acute coronary syndrome is infrequent, presents most often as non-STEMI, but is associated with high early mortality.

Although as many as 50% of patients who undergo transcatheter aortic-valve replacement (TAVR) have known coronary artery disease, the incidence of acute coronary syndrome (ACS) after TAVR is unknown. In a study using data on Medicare admissions occurring between 2012 and 2017, investigators identified 142,845 patients who underwent TAVR; 6741 (4.7%) had a subsequent ACS admission (mean age, 81; 55% men; black race, 5%).

Compared with non-ACS patients, those with ACS were younger and more likely to be male and of black race. The presenting ACS diagnoses were ST-segment elevation myocardial infarction (STEMI; 9%), non-STEMI (88%), and unstable angina (3%). Strong predictors of ACS included prior ACS (odds ratio, 2.97) and valve-in-TAVR (OR, 2.…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)