Early transcatheter aortic valve replacement bests clinical surveillance for reducing death, stroke, unplanned hospitalization
By Elana Gotkine HealthDay Reporter
FRIDAY, Nov. 1, 2024 (HealthDay News) — Early transcatheter aortic valve replacement (TAVR) is better than clinical surveillance for reducing the incidence of death, stroke, and unplanned hospitalization for cardiovascular causes among patients with asymptomatic severe aortic stenosis, according to a study published online Oct. 28 in the New England Journal of Medicine. The research was published to coincide with the annual Transcatheter Cardiovascular Therapeutics conference, held from Oct. 27 to 30 in Washington, D.C.
Philippe Généreux, M.D., from Morristown Medical Center in New Jersey, and colleagues randomly assigned patients from 75 centers with asymptomatic severe aortic stenosis to undergo early TAVR with transfemoral placement of a balloon-expandable valve or clinical surveillance (455 and 446 patients, respectively).
The researchers found that 26.8 and 45.3 percent of patients in the TAVR and clinical surveillance groups had a primary end point event (composite of death, stroke, or unplanned hospitalization for cardiovascular causes; hazard ratio, 0.50). Among patients assigned to TAVR and clinical surveillance, death occurred in 8.4 and 9.2 percent, respectively; stroke in 4.2 and 6.7 percent; and unplanned hospitalization for cardiovascular causes in 20.9 and 41.7 percent. Eighty-seven percent of patients in the clinical surveillance group underwent aortic valve replacement during a median follow-up of 3.8 years.
“Among patients with asymptomatic severe aortic stenosis, a strategy of early TAVR was superior to guideline-recommended clinical surveillance in reducing the composite end point of death, stroke, or unplanned hospitalization for cardiovascular causes,” the authors write.
The study was funded by Edwards Lifesciences.
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