Trends and Outcomes in Patients with Coronary Artery Disease Undergoing TAVR: Insights from VA CART

BackgroundObstructive coronary artery disease (CAD) is common in patients with severe symptomatic aortic stenosis. The management and impact of obstructive CAD undergoing transcatheter valve replacement (TAVR) have not been fully evaluated. We aimed to determine the patient characteristics clinical outcomes among veterans TAVR without temporal trends association pre-TAVR percutaneous intervention (PCI) outcomes.MethodsWe identified all who underwent from 2012 2021 VA Health Care System. sample population was divided into further stratified by status 1 year prior TAVR. primary outcome 1-year all-cause mortality, secondary major bleeding.ResultsDuring study period, 759 TAVR, 282 (37%) had CAD. Obstructive associated higher mortality (15.6% vs 7.1%; P < .01) after rate PCI increased until 2016, which it steadily declined such that 144 (51%) during entire period. There no difference (16.0% 15.2%; = .89) or bleeding (16.7% 12.3%; .33) between did undergo PCI.ConclusionsAmong Veterans presence though improved outcomes. Further studies could identify a subset may benefit revascularization