ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement

Laurent Faroux; Thibault Lhermusier; Flavien Vincent; Luis Nombela-Franco; Didier Tchétché; Marco Barbanti; Mohamed Abdel-Wahab; Stephan Windecker; Vincent Auffret; Diego Carter Campanha-Borges; Quentin Fischer; Erika Muñoz-Garcia; Ramiro Trillo-Nouche; Troels Jorgensen; Vicens Serra; Stefan Toggweiler; Giuseppe Tarantini; Francesco Saia; Eric Durand; Pierre Donaint; Enrique Gutierrez-Ibanes; Harindra C. Wijeysundera; Gabriela Veiga; Giuseppe Patti; Fabrizio D'Ascenzo; Raul Moreno; Christian Hengstenberg; Chekrallah Chamandi; Lluis Asmarats; Rosana Hernandez-Antolin; Joan Antoni Gomez-Hospital; Juan Gabriel Cordoba-Soriano; Uri Landes; Victor Alfonso Jimenez-Diaz; Ignacio Cruz-Gonzalez; Mohammed Nejjari; François Roubille; Éric Van Belle; German Armijo; Saifullah Siddiqui; Giuliano Costa; Sameh Elsaify; Thomas Pilgrim; Hervé le Breton; Marina Urena; Antonio Jesus Muñoz-Garcia; Lars Sondergaard; Montserrat Bach-Oller; Chiara Fraccaro; Hélène Eltchaninoff; Damien Metz; Maria Tamargo; Victor Fradejas-Sastre; Andrea Rognoni; Francesco Bruno; Georg Goliasch; Marcelo Santaló-Corcoy; Jesus Jimenez-Mazuecos; John G. Webb; Guillem Muntané-Carol; Jean Michal Paradis; Antonio Mangieri; Henrique Barbosa Ribeiro; Francisco Campelo-Parada; Josep Rodés-Cabau

doi:10.1016/j.jacc.2021.03.014

ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement

Laurent Faroux
, Thibault Lhermusier
, Flavien Vincent
, Luis Nombela-Franco
, Didier Tchétché
, Marco Barbanti
, Mohamed Abdel-Wahab
, Stephan Windecker
, Vincent Auffret
, Diego Carter Campanha-Borges
, Quentin Fischer
, Erika Muñoz-Garcia
, Ramiro Trillo-Nouche
, Troels Jorgensen
, Vicens Serra
, Stefan Toggweiler
, Giuseppe Tarantini
, Francesco Saia
, Eric Durand
, Pierre Donaint

Enrique Gutierrez-Ibanes, Harindra C. Wijeysundera, Gabriela Veiga, Giuseppe Patti, Fabrizio D'Ascenzo, Raul Moreno, Christian Hengstenberg, Chekrallah Chamandi, Lluis Asmarats, Rosana Hernandez-Antolin, Joan Antoni Gomez-Hospital, Juan Gabriel Cordoba-Soriano, Uri Landes, Victor Alfonso Jimenez-Diaz, Ignacio Cruz-Gonzalez, Mohammed Nejjari, François Roubille, Éric Van Belle, German Armijo, Saifullah Siddiqui, Giuliano Costa, Sameh Elsaify, Thomas Pilgrim, Hervé le Breton, Marina Urena, Antonio Jesus Muñoz-Garcia, Lars Sondergaard, Montserrat Bach-Oller, Chiara Fraccaro, Hélène Eltchaninoff, Damien Metz, Maria Tamargo, Victor Fradejas-Sastre, Andrea Rognoni, Francesco Bruno, Georg Goliasch, Marcelo Santaló-Corcoy, Jesus Jimenez-Mazuecos, John G. Webb, Guillem Muntané-Carol, Jean Michal Paradis, Antonio Mangieri, Henrique Barbosa Ribeiro, Francisco Campelo-Parada, Josep Rodés-Cabau

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Among patients with acute coronary syndrome following transcatheter aortic valve replacement (TAVR), those presenting with ST-segment elevation myocardial infarction (STEMI) are at highest risk. Objectives: The goal of this study was to determine the clinical characteristics, management, and outcomes of STEMI after TAVR. Methods: This was a multicenter study including 118 patients presenting with STEMI at a median of 255 days (interquartile range: 9 to 680 days) after TAVR. Procedural features of STEMI after TAVR managed with primary percutaneous coronary intervention (PCI) were compared with all-comer STEMI: 439 non-TAVR patients who had primary PCI within the 2 weeks before and after each post-TAVR STEMI case in 5 participating centers from different countries. Results: Median door-to-balloon time was higher in TAVR patients (40 min [interquartile range: 25 to 57 min] vs. 30 min [interquartile range: 25 to 35 min]; p = 0.003). Procedural time, fluoroscopy time, dose-area product, and contrast volume were also higher in TAVR patients (p < 0.01 for all). PCI failure occurred more frequently in patients with previous TAVR (16.5% vs. 3.9%; p < 0.001), including 5 patients in whom the culprit lesion was not revascularized owing to coronary ostia cannulation failure. In-hospital and late (median of 7 months [interquartile range: 1 to 21 months]) mortality rates were 25.4% and 42.4%, respectively (20.6% and 38.2% in primary PCI patients), and estimated glomerular filtration rate <60 ml/min (hazard ratio [HR]: 3.02; 95% confidence interval [CI]: 1.42 to 6.43; p = 0.004), Killip class ≥2 (HR: 2.74; 95% CI: 1.37 to 5.49; p = 0.004), and PCI failure (HR: 3.23; 95% CI: 1.42 to 7.31; p = 0.005) determined an increased risk. Conclusions: STEMI after TAVR was associated with very high in-hospital and mid-term mortality. Longer door-to-balloon times and a higher PCI failure rate were observed in TAVR patients, partially due to coronary access issues specific to the TAVR population, and this was associated with poorer outcomes.

Original language	English
Pages (from-to)	2187-2199
Number of pages	13
Journal	Journal of the American College of Cardiology
Volume	77
Issue number	17
DOIs	https://doi.org/10.1016/j.jacc.2021.03.014
Publication status	Published - 4 May 2021
Externally published	Yes

Keywords

ST-segment elevation myocardial infarction
acute coronary syndrome
mortality
percutaneous coronary intervention
transcatheter aortic valve replacement

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10.1016/j.jacc.2021.03.014

Cite this

Faroux, L., Lhermusier, T., Vincent, F., Nombela-Franco, L., Tchétché, D., Barbanti, M., Abdel-Wahab, M., Windecker, S., Auffret, V., Campanha-Borges, D. C., Fischer, Q., Muñoz-Garcia, E., Trillo-Nouche, R., Jorgensen, T., Serra, V., Toggweiler, S., Tarantini, G., Saia, F., Durand, E., ... Rodés-Cabau, J. (2021). ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement. Journal of the American College of Cardiology, 77(17), 2187-2199. https://doi.org/10.1016/j.jacc.2021.03.014

@article{f8bdbc0cfb984b01b7077f193a2a8a00,

title = "ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement",

abstract = "Background: Among patients with acute coronary syndrome following transcatheter aortic valve replacement (TAVR), those presenting with ST-segment elevation myocardial infarction (STEMI) are at highest risk. Objectives: The goal of this study was to determine the clinical characteristics, management, and outcomes of STEMI after TAVR. Methods: This was a multicenter study including 118 patients presenting with STEMI at a median of 255 days (interquartile range: 9 to 680 days) after TAVR. Procedural features of STEMI after TAVR managed with primary percutaneous coronary intervention (PCI) were compared with all-comer STEMI: 439 non-TAVR patients who had primary PCI within the 2 weeks before and after each post-TAVR STEMI case in 5 participating centers from different countries. Results: Median door-to-balloon time was higher in TAVR patients (40 min [interquartile range: 25 to 57 min] vs. 30 min [interquartile range: 25 to 35 min]; p = 0.003). Procedural time, fluoroscopy time, dose-area product, and contrast volume were also higher in TAVR patients (p < 0.01 for all). PCI failure occurred more frequently in patients with previous TAVR (16.5\% vs. 3.9\%; p < 0.001), including 5 patients in whom the culprit lesion was not revascularized owing to coronary ostia cannulation failure. In-hospital and late (median of 7 months [interquartile range: 1 to 21 months]) mortality rates were 25.4\% and 42.4\%, respectively (20.6\% and 38.2\% in primary PCI patients), and estimated glomerular filtration rate <60 ml/min (hazard ratio [HR]: 3.02; 95\% confidence interval [CI]: 1.42 to 6.43; p = 0.004), Killip class ≥2 (HR: 2.74; 95\% CI: 1.37 to 5.49; p = 0.004), and PCI failure (HR: 3.23; 95\% CI: 1.42 to 7.31; p = 0.005) determined an increased risk. Conclusions: STEMI after TAVR was associated with very high in-hospital and mid-term mortality. Longer door-to-balloon times and a higher PCI failure rate were observed in TAVR patients, partially due to coronary access issues specific to the TAVR population, and this was associated with poorer outcomes.",

keywords = "ST-segment elevation myocardial infarction, acute coronary syndrome, mortality, percutaneous coronary intervention, transcatheter aortic valve replacement",

author = "Laurent Faroux and Thibault Lhermusier and Flavien Vincent and Luis Nombela-Franco and Didier Tch{\'e}tch{\'e} and Marco Barbanti and Mohamed Abdel-Wahab and Stephan Windecker and Vincent Auffret and Campanha-Borges, \{Diego Carter\} and Quentin Fischer and Erika Mu{\~n}oz-Garcia and Ramiro Trillo-Nouche and Troels Jorgensen and Vicens Serra and Stefan Toggweiler and Giuseppe Tarantini and Francesco Saia and Eric Durand and Pierre Donaint and Enrique Gutierrez-Ibanes and Wijeysundera, \{Harindra C.\} and Gabriela Veiga and Giuseppe Patti and Fabrizio D'Ascenzo and Raul Moreno and Christian Hengstenberg and Chekrallah Chamandi and Lluis Asmarats and Rosana Hernandez-Antolin and Gomez-Hospital, \{Joan Antoni\} and Cordoba-Soriano, \{Juan Gabriel\} and Uri Landes and Jimenez-Diaz, \{Victor Alfonso\} and Ignacio Cruz-Gonzalez and Mohammed Nejjari and Fran{\c c}ois Roubille and \{Van Belle\}, {\'E}ric and German Armijo and Saifullah Siddiqui and Giuliano Costa and Sameh Elsaify and Thomas Pilgrim and \{le Breton\}, Herv{\'e} and Marina Urena and Mu{\~n}oz-Garcia, \{Antonio Jesus\} and Lars Sondergaard and Montserrat Bach-Oller and Chiara Fraccaro and H{\'e}l{\`e}ne Eltchaninoff and Damien Metz and Maria Tamargo and Victor Fradejas-Sastre and Andrea Rognoni and Francesco Bruno and Georg Goliasch and Marcelo Santal{\'o}-Corcoy and Jesus Jimenez-Mazuecos and Webb, \{John G.\} and Guillem Muntan{\'e}-Carol and Paradis, \{Jean Michal\} and Antonio Mangieri and Ribeiro, \{Henrique Barbosa\} and Francisco Campelo-Parada and Josep Rod{\'e}s-Cabau",

note = "Publisher Copyright: {\textcopyright} 2021 American College of Cardiology Foundation",

year = "2021",

month = may,

day = "4",

doi = "10.1016/j.jacc.2021.03.014",

language = "English",

volume = "77",

pages = "2187--2199",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier Inc.",

number = "17",

}

Faroux, L, Lhermusier, T, Vincent, F, Nombela-Franco, L, Tchétché, D, Barbanti, M, Abdel-Wahab, M, Windecker, S, Auffret, V, Campanha-Borges, DC, Fischer, Q, Muñoz-Garcia, E, Trillo-Nouche, R, Jorgensen, T, Serra, V, Toggweiler, S, Tarantini, G, Saia, F, Durand, E, Donaint, P, Gutierrez-Ibanes, E, Wijeysundera, HC, Veiga, G, Patti, G, D'Ascenzo, F, Moreno, R, Hengstenberg, C, Chamandi, C, Asmarats, L, Hernandez-Antolin, R, Gomez-Hospital, JA, Cordoba-Soriano, JG, Landes, U, Jimenez-Diaz, VA, Cruz-Gonzalez, I, Nejjari, M, Roubille, F, Van Belle, É, Armijo, G, Siddiqui, S, Costa, G, Elsaify, S, Pilgrim, T, le Breton, H, Urena, M, Muñoz-Garcia, AJ, Sondergaard, L, Bach-Oller, M, Fraccaro, C, Eltchaninoff, H, Metz, D, Tamargo, M, Fradejas-Sastre, V, Rognoni, A, Bruno, F, Goliasch, G, Santaló-Corcoy, M, Jimenez-Mazuecos, J, Webb, JG, Muntané-Carol, G, Paradis, JM, Mangieri, A, Ribeiro, HB, Campelo-Parada, F & Rodés-Cabau, J 2021, 'ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement', Journal of the American College of Cardiology, vol. 77, no. 17, pp. 2187-2199. https://doi.org/10.1016/j.jacc.2021.03.014

TY - JOUR

T1 - ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement

AU - Faroux, Laurent

AU - Lhermusier, Thibault

AU - Vincent, Flavien

AU - Nombela-Franco, Luis

AU - Tchétché, Didier

AU - Barbanti, Marco

AU - Abdel-Wahab, Mohamed

AU - Windecker, Stephan

AU - Auffret, Vincent

AU - Campanha-Borges, Diego Carter

AU - Fischer, Quentin

AU - Muñoz-Garcia, Erika

AU - Trillo-Nouche, Ramiro

AU - Jorgensen, Troels

AU - Serra, Vicens

AU - Toggweiler, Stefan

AU - Tarantini, Giuseppe

AU - Saia, Francesco

AU - Durand, Eric

AU - Donaint, Pierre

AU - Gutierrez-Ibanes, Enrique

AU - Wijeysundera, Harindra C.

AU - Veiga, Gabriela

AU - Patti, Giuseppe

AU - D'Ascenzo, Fabrizio

AU - Moreno, Raul

AU - Hengstenberg, Christian

AU - Chamandi, Chekrallah

AU - Asmarats, Lluis

AU - Hernandez-Antolin, Rosana

AU - Gomez-Hospital, Joan Antoni

AU - Cordoba-Soriano, Juan Gabriel

AU - Landes, Uri

AU - Jimenez-Diaz, Victor Alfonso

AU - Cruz-Gonzalez, Ignacio

AU - Nejjari, Mohammed

AU - Roubille, François

AU - Van Belle, Éric

AU - Armijo, German

AU - Siddiqui, Saifullah

AU - Costa, Giuliano

AU - Elsaify, Sameh

AU - Pilgrim, Thomas

AU - le Breton, Hervé

AU - Urena, Marina

AU - Muñoz-Garcia, Antonio Jesus

AU - Sondergaard, Lars

AU - Bach-Oller, Montserrat

AU - Fraccaro, Chiara

AU - Eltchaninoff, Hélène

AU - Metz, Damien

AU - Tamargo, Maria

AU - Fradejas-Sastre, Victor

AU - Rognoni, Andrea

AU - Bruno, Francesco

AU - Goliasch, Georg

AU - Santaló-Corcoy, Marcelo

AU - Jimenez-Mazuecos, Jesus

AU - Webb, John G.

AU - Muntané-Carol, Guillem

AU - Paradis, Jean Michal

AU - Mangieri, Antonio

AU - Ribeiro, Henrique Barbosa

AU - Campelo-Parada, Francisco

AU - Rodés-Cabau, Josep

PY - 2021/5/4

Y1 - 2021/5/4

N2 - Background: Among patients with acute coronary syndrome following transcatheter aortic valve replacement (TAVR), those presenting with ST-segment elevation myocardial infarction (STEMI) are at highest risk. Objectives: The goal of this study was to determine the clinical characteristics, management, and outcomes of STEMI after TAVR. Methods: This was a multicenter study including 118 patients presenting with STEMI at a median of 255 days (interquartile range: 9 to 680 days) after TAVR. Procedural features of STEMI after TAVR managed with primary percutaneous coronary intervention (PCI) were compared with all-comer STEMI: 439 non-TAVR patients who had primary PCI within the 2 weeks before and after each post-TAVR STEMI case in 5 participating centers from different countries. Results: Median door-to-balloon time was higher in TAVR patients (40 min [interquartile range: 25 to 57 min] vs. 30 min [interquartile range: 25 to 35 min]; p = 0.003). Procedural time, fluoroscopy time, dose-area product, and contrast volume were also higher in TAVR patients (p < 0.01 for all). PCI failure occurred more frequently in patients with previous TAVR (16.5% vs. 3.9%; p < 0.001), including 5 patients in whom the culprit lesion was not revascularized owing to coronary ostia cannulation failure. In-hospital and late (median of 7 months [interquartile range: 1 to 21 months]) mortality rates were 25.4% and 42.4%, respectively (20.6% and 38.2% in primary PCI patients), and estimated glomerular filtration rate <60 ml/min (hazard ratio [HR]: 3.02; 95% confidence interval [CI]: 1.42 to 6.43; p = 0.004), Killip class ≥2 (HR: 2.74; 95% CI: 1.37 to 5.49; p = 0.004), and PCI failure (HR: 3.23; 95% CI: 1.42 to 7.31; p = 0.005) determined an increased risk. Conclusions: STEMI after TAVR was associated with very high in-hospital and mid-term mortality. Longer door-to-balloon times and a higher PCI failure rate were observed in TAVR patients, partially due to coronary access issues specific to the TAVR population, and this was associated with poorer outcomes.

AB - Background: Among patients with acute coronary syndrome following transcatheter aortic valve replacement (TAVR), those presenting with ST-segment elevation myocardial infarction (STEMI) are at highest risk. Objectives: The goal of this study was to determine the clinical characteristics, management, and outcomes of STEMI after TAVR. Methods: This was a multicenter study including 118 patients presenting with STEMI at a median of 255 days (interquartile range: 9 to 680 days) after TAVR. Procedural features of STEMI after TAVR managed with primary percutaneous coronary intervention (PCI) were compared with all-comer STEMI: 439 non-TAVR patients who had primary PCI within the 2 weeks before and after each post-TAVR STEMI case in 5 participating centers from different countries. Results: Median door-to-balloon time was higher in TAVR patients (40 min [interquartile range: 25 to 57 min] vs. 30 min [interquartile range: 25 to 35 min]; p = 0.003). Procedural time, fluoroscopy time, dose-area product, and contrast volume were also higher in TAVR patients (p < 0.01 for all). PCI failure occurred more frequently in patients with previous TAVR (16.5% vs. 3.9%; p < 0.001), including 5 patients in whom the culprit lesion was not revascularized owing to coronary ostia cannulation failure. In-hospital and late (median of 7 months [interquartile range: 1 to 21 months]) mortality rates were 25.4% and 42.4%, respectively (20.6% and 38.2% in primary PCI patients), and estimated glomerular filtration rate <60 ml/min (hazard ratio [HR]: 3.02; 95% confidence interval [CI]: 1.42 to 6.43; p = 0.004), Killip class ≥2 (HR: 2.74; 95% CI: 1.37 to 5.49; p = 0.004), and PCI failure (HR: 3.23; 95% CI: 1.42 to 7.31; p = 0.005) determined an increased risk. Conclusions: STEMI after TAVR was associated with very high in-hospital and mid-term mortality. Longer door-to-balloon times and a higher PCI failure rate were observed in TAVR patients, partially due to coronary access issues specific to the TAVR population, and this was associated with poorer outcomes.

KW - ST-segment elevation myocardial infarction

KW - acute coronary syndrome

KW - mortality

KW - percutaneous coronary intervention

KW - transcatheter aortic valve replacement

UR - https://www.scopus.com/pages/publications/85104410822

U2 - 10.1016/j.jacc.2021.03.014

DO - 10.1016/j.jacc.2021.03.014

M3 - Article

SN - 0735-1097

VL - 77

SP - 2187

EP - 2199

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 17

ER -

ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement

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