Peak aortic jet velocity as a predictor of short- and long-term outcomes following percutaneous coronary intervention.

Background: Coronary artery disease (CAD) and aortic valve stenosis (AS) often coexist, with AS exacerbating myocardial ischemia and affecting prognosis. Aims: To investigate the prognostic impact of AS stratified by peak aortic jet velocity (AV-Vel) in patients undergoing PCI. Methods and results: We conducted retrospective multicenter observational study involving patients who underwent percutaneous coronary intervention (PCI) between April 2013 and March 2019. The patients were divided into non-AS group and AS group. The AS group was further categorized: 2.6 ≤ AV-Vel < 3.0 m/s, mild AS; 3.0 ≤ AV-Vel < 4.0 m/s, moderate AS; and AV-Vel ≥ 4.0 m/s, severe AS. The primary outcome was all-cause mortality, and the secondary outcome was major adverse cardiovascular events (MACE), defined as a composite of all-cause mortality, myocardial infarction, or stroke. Multivariable Cox proportional hazards analysis was performed over 5-year observation period, with landmark analyses conducted at 30 days after PCI and from day 31 after PCI to 5 years. In total, 9,690 patients were analyzed (AS group, n = 361). Over a median follow-up of 2.57 (IQR: 0.89-4.24) years, AS group exhibited higher rates of mortality (HR: 3.06; 95% CI: 2.41-3.90; p < 0.001) and MACE (HR: 2.45; 95%CI: 1.97-3.04; p < 0.001) compared with non-AS group. Subgroup analysis revealed that patients with moderate and severe AS had worse short-term mortality and MACE within 30 days after PCI than the non-AS group, while patients with mild to severe AS showed significantly worse long-term outcomes than the non-AS group. Conclusions: AV-Vel is independently associated with both short- and long-term outcomes in patients undergoing PCI.