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Coronary heart disease

Transcatheter vs Surgical Treatment in Aortic Stenosis with Coronary Artery Disease: Meta-Analysis of Time-to-Event Data

Strategic Insights

— 1 min read

A new meta-analysis published in the journal Heart & Lung has shed light on the effectiveness of transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) versus surgical aortic valve replacement (SAVR) with coronary artery bypass graft (CABG) in patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD). The study, conducted by researchers from Al-Azhar University in Cairo, Egypt, analyzed data from 15 studies involving 162,305 patients.

Key Takeaways:

  • The meta-analysis found that TAVR with PCI was associated with higher all-cause mortality at 48 months compared to CABG with SAVR (HR 1.29, 95% CI 1.23-1.35, p < 0.0001).
  • Patients undergoing TAVR with PCI had a higher risk of myocardial infarction at 30 days (RR 1.61, 95% CI 1.08-2.39, p = 0.01).
  • The comparative study identified conflicting evidence regarding the perioperative risk and survival benefits of TAVR with PCI versus CABG with SAVR.
  • The authors concluded that high-quality randomized trials are warranted to confirm these findings and establish the most effective treatment strategy for patients with concomitant AS and CAD.

Statistics:

  • 162,305 patients were involved in the 15 studies analyzed in the meta-analysis.
  • The combined data showed a significant association between TAVR with PCI and higher all-cause mortality at 48 months (HR 1.29, 95% CI 1.23-1.35, p < 0.0001).
  • The risk ratio for myocardial infarction at 30 days was 1.61 (95% CI 1.08-2.39, p = 0.01) for TAVR with PCI compared to CABG with SAVR.
  • The study demonstrated conflicting evidence regarding the survival benefits of TAVR with PCI versus CABG with SAVR.

Sources:

  • Transcatheter versus surgical treatment in aortic stenosis with coronary artery disease: A meta-analysis of time-to-event data on 162,305 patients. Heart & Lung, 2025;75:184-197.
  • Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA (publisher contact information for the journal Heart & Lung).
  • Al-Azhar University, Cairo, Egypt (research institution).

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