Coronary Artery Disease in Elderly People Referred for TAVI

  • STATUS
    Recruiting
  • End date
    Nov 1, 2023
  • participants needed
    170
  • sponsor
    University Hospital, Montpellier
Updated on 24 June 2021
stenosis
tavi

Summary

The investigators prognostic impact of coronary artery disease (CAD) and of percutaneous coronary intervention (PCI) in patients with indication of TAVI is controversial, particularly in elderly population where CAD and aortic stenosis (AS) are frequent and commonly coexisted. (1-2) The primary end point of this prospective study is to compare major cardiovascular event at one year of follow up in patients over 80 years with severe aortic stenosis who referred for TAVI with or without associated CAD.

The investigators will also assess (secondary endpoint) the impact of PCI on symptoms, major events and quality of life using geriatric parameters. The study will be conducted in the University hospital of Montpellier between November 2020 and November 2022

Description

Patients will be prospectively included in the study when aged of 80 years old or over and referred for TAVI at the university hospital of Montpellier.

Two groups of patients will be considered after coronary angiography which is systematic before TAVI Group 1: patients with significant > 50 % narrowing coronary stenosis ( revascularization by PCI / no revascularization) Group 2: No coronary lesion

Considering an end point at 1 year and a precision wished to i 6 percent with an alpha risk of 5 %, it's proposed , by the formula p= [(1.96)2 x [p(1-p)] / i2 ], a number of 170 subjects needed to highlight a incidence of major cardio-vascular event of 20 percent in the studied population.

Data collection by informatic files will include :

  • Cardio vascular risk factor and medical history with evaluation of Charlston score
  • Previous drug therapy
  • Lifestyle : living alone or not, nursing home, ; home help
  • Symptoms (angina (CSS classification) ; dyspnea (NHYA classification))
  • Renal function (DFG) at admission
  • Results of coronary angiography (number of lesions, proximal or non proximal, location of coronary stenosis)
  • Geriatric assessment : autonomy, disability in daily living, weigh, BMI, falls, cognitive functions tests, assessment of the mood state by GDS
  • Results of TAVI (success and complications of the procedure according to VARC2 criteria)
  • Results of coronary revascularization if performed
  • Length of hospitalisation for TAVI (days), length of stay in ICU (Intensive Care Unit) if necessary
  • Events during the hospitalisation for TAVI (VARC and BARC criterias)

Follow up at 6 month (middle analysis) and at one year (primary end point) by phone conversation with the patient for assessment of :

  • Major cardio-vascular events
  • Hospitalisation occurred
  • Short geriatric evaluation including :
  • cognition by Ottawa3DY
  • autonomy by ADL
  • polypharmacy
  • number of fall in the past 6 month
  • last weight
  • quality of life (Fried criterias)
  • mood state by GDS If neurocognitive disorders are known or discovers, data patient's validity will be check by calling his caregiver and/or his general practitioner (if caregiver not available).

Analysis associated of the computerized patient record.

Details
Condition Aortic Stenosis, VALVULAR HEART DISEASE, aortic valve stenosis, Coronary Ang, Heart Valve Disease
Clinical Study IdentifierNCT04930510
SponsorUniversity Hospital, Montpellier
Last Modified on24 June 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

patient aged 80 and over
hospital admission for evaluation before TAVI indicated for symptomatic and severe aortic stenosis
patient's consent

Exclusion Criteria

absence of coronarography
severe angina (class 3 or 4)
stenosis of left main coronary artery > 50%
stenosis of the left anterior descending artery > 90%
decision of surgical valve replacement
Clear my responses

How to participate?

Step 1 Connect with a study center
What happens next?
  • You can expect the study team to contact you via email or phone in the next few days.
  • Sign up as volunteer  to help accelerate the development of new treatments and to get notified about similar trials.

You are contacting

Investigator Avatar

Primary Contact

site

Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

Learn more

If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

Learn more

Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

Learn more

Similar trials to consider

Loading...

Browse trials for

Not finding what you're looking for?

Every year hundreds of thousands of volunteers step forward to participate in research. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.

Sign up as volunteer

user name

Added by • 

 • 

Private

Reply by • Private
Loading...

Lorem ipsum dolor sit amet consectetur, adipisicing elit. Ipsa vel nobis alias. Quae eveniet velit voluptate quo doloribus maxime et dicta in sequi, corporis quod. Ea, dolor eius? Dolore, vel!

  The passcode will expire in None.
Loading...

No annotations made yet

Add a private note
  • abc Select a piece of text from the left.
  • Add notes visible only to you.
  • Send it to people through a passcode protected link.
Add a private note