Faroux, LaurentLhermusier, ThibaultVincent, FlavienNombela-Franco, LuisTchétché, DidierBarbanti, MarcoAbdel-Wahab, MohamedWindecker, StephanAuffret, VincentCampanha-Borges, Diego CarterFischer, QuentinMuñoz-Garcia, ErikaTrillo-Nouche, RamiroJorgensen, TroelsSerra, VicensToggweiler, StefanTarantini, GiuseppeSaia, FrancescoDurand, EricDonaint, PierreGutierrez-Ibanes, EnriqueWijeysundera, Harindra CVeiga, GabrielaPatti, GiuseppeD'Ascenzo, FabrizioMoreno, RaulHengstenberg, ChristianChamandi, ChekrallahAsmarats, LluisHernandez-Antolin, RosanaGomez-Hospital, Joan AntoniCordoba-Soriano, Juan GabrielLandes, UriJimenez-Diaz, Victor AlfonsoCruz-Gonzalez, IgnacioNejjari, MohammedRoubille, FrançoisVan Belle, ÉricArmijo, GermanSiddiqui, SaifullahCosta, GiulianoElsaify, SamehPilgrim, Thomasle Breton, HervéUrena, MarinaMuñoz-Garcia, Antonio JesusSondergaard, LarsBach-Oller, MontserratFraccaro, ChiaraEltchaninoff, HélèneMetz, DamienTamargo, MariaFradejas-Sastre, VictorRognoni, AndreaBruno, FrancescoGoliasch, GeorgSantaló-Corcoy, MarceloJimenez-Mazuecos, JesusWebb, John GMuntané-Carol, GuillemParadis, Jean-MichalMangieri, AntonioRibeiro, Henrique BarbosaCampelo-Parada, FranciscoRodés-Cabau, Josep2023-02-092023-02-092021http://hdl.handle.net/10668/17727Among patients with acute coronary syndrome following transcatheter aortic valve replacement (TAVR), those presenting with ST-segment elevation myocardial infarction (STEMI) are at highest risk. The goal of this study was to determine the clinical characteristics, management, and outcomes of STEMI after TAVR. This was a multicenter study including 118 patients presenting with STEMI at a median of 255 days (interquartile range: 9 to 680 days) after TAVR. Procedural features of STEMI after TAVR managed with primary percutaneous coronary intervention (PCI) were compared with all-comer STEMI: 439 non-TAVR patients who had primary PCI within the 2 weeks before and after each post-TAVR STEMI case in 5 participating centers from different countries. Median door-to-balloon time was higher in TAVR patients (40 min [interquartile range: 25 to 57 min] vs. 30 min [interquartile range: 25 to 35 min]; p = 0.003). Procedural time, fluoroscopy time, dose-area product, and contrast volume were also higher in TAVR patients (p  STEMI after TAVR was associated with very high in-hospital and mid-term mortality. Longer door-to-balloon times and a higher PCI failure rate were observed in TAVR patients, partially due to coronary access issues specific to the TAVR population, and this was associated with poorer outcomes.enST-segment elevation myocardial infarctionacute coronary syndromemortalitypercutaneous coronary interventiontranscatheter aortic valve replacementAged, 80 and overAortic Valve StenosisCoronary AngiographyFemaleFollow-Up StudiesGlobal HealthHospital MortalityHumansIncidenceMalePercutaneous Coronary InterventionPostoperative ComplicationsRisk AssessmentRisk FactorsST Elevation Myocardial InfarctionTime FactorsTranscatheter Aortic Valve Replacementresearch article33926655open access10.1016/j.jacc.2021.03.0141558-3597https://doi.org/10.1016/j.jacc.2021.03.014