Abstract 4145001: Renal Outcomes of Staged Versus Concomitant Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement: A meta-analysis

Background: The impact of staged on renal outcomes percutaneous coronary intervention (PCI) in patients undergoing transcatheter aortic valve replacement (TAVR) is uncertain. Methods: MEDLINE, Embase, and Cochrane were systematically searched for studies comparing staged versus concomitant PCI in patients with aortic stenosis and coronary artery disease undergoing TAVR and PCI. A random-effects model meta-analysis calculates the odds ratio (OR) with a 95% confidence interval (CI). Our outcome of interest was the incidence of contrast-induced acute coronary injury (CI-AKI) and its respective stages. Results: 11 studies comprising 6,056 patients undergoing TAVR and PCI were included. Compared with concomitant PCI, staged PCI did not reduce the incidence of CI-AKI (OR 0.89; 95% CI 0.48-1.64; p=0.70; Figure 1). In a subgroup analysis, there was no difference between staged and concomitant PCI in the incidence of stage 1 CI-AKI (OR 1.99; 95% CI 0.38-10.47; p=0.70), stage 2 CI-AKI (OR 1.01; 95% CI 0.39-2.64; p=0.70), and stage 3 CI-AKI (OR 0.48; 95% CI 0.23-1.00; p=0.051). Conclusion: In patients undergoing TAVR, there was no difference between staged versus concomitant PCI in the incidence of contrast-induced nephropathy.