If you need a new heart valve and also have blocked arteries, should doctors clear those blockages first? A new analysis suggests the answer may be no.
Researchers combined data from 5 trials involving 1,156 patients with severe aortic stenosis and coronary artery disease. They compared people who got angioplasty (PCI) before valve replacement (TAVR) to those who didn't. The result: no difference in deaths from any cause or from heart problems over the follow-up period.
But there was a trade-off. People who had PCI first were less likely to need another procedure to open arteries later. However, they had nearly double the risk of any bleeding and major bleeding. Other outcomes like heart attack, stroke, kidney injury, and rehospitalization were similar between groups.
This is a meta-analysis, which combines past studies. The findings are not definitive, but they suggest that routine PCI before TAVR may not be necessary for everyone. Instead, doctors should consider each patient's individual situation before deciding on angioplasty.
