In this study-level meta-analysis of randomized controlled trials (RCTs) evaluating the effect of early aortic valve replacement (AVR) versus clinical surveillance (CS) in patients with asymptomatic severe aortic stenosis (AS), four RCTs were identified and included for analysis: AVATAR, RECOVERY, EARLY TAVR, EVOLVED. Prespecified outcomes included all-cause and cardiovascular mortality, unplanned cardiovascular or heart failure (HF) hospitalization, and stroke. A total of 1,427 patients (719 in the early AVR group and 708 in the CS group) were included for analysis.
At an average follow-up time of 4.1 years, early AVR was associated with a significant reduction in unplanned cardiovascular or HF hospitalization (14.6 percent versus 31.9 percent; HR: 0.40; 95 percent CI: 0.30-0.53;P
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Aortic Valve Replacement vs Clinical Surveillance in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta-Analysis
Source: Journal of the American College of Cardiology
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Author(s): Philippe Généreux, Marko Banovic, Duk-Hyun Kang, Gennaro Giustino, Bernard D. Prendergast, Brian R. Lindman, David E. Newby, Philippe Pibarot, Björn Redfors, Neil J. Craig, Jozef Bartunek, Allan Schwartz, Roxanna Seyedin, David J. Cohen, Bernard Iung, Martin B. Leon, Marc R. Dweck
