Timing of PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation.

Performing TAVI before PCI is noninferior to PCI before TAVI regarding 1-year outcomes in patients with severe aortic stenosis and coronary artery disease, with a 22.2% versus 24.2% event rate.

• Why it matters: Optimal timing of PCI in conjunction with TAVI remains uncertain, impacting treatment strategies and patient outcomes for those with coexisting coronary artery disease.
• What they did: An international randomized trial assigned 986 patients to TAVI-first or PCI-first strategies, comparing their 1-year composite outcomes including death, myocardial infarction, revascularization, rehospitalization, and major bleeding.
• The result: TAVI before PCI demonstrated noninferiority, with similar adverse event rates, supporting flexible sequencing options to improve clinical decision-making and patient care.