Key result
AVR linked to ~41% lower 5-year mortality vs surveillance in moderate AS.
Why the study?
Emerging evidence of substantial mortality in untreated moderate AS and improved AVR safety have challenged the traditional risk/benefit paradigm, warranting an appraisal of contemporary data and intervention timing.
Does aortic valve replacement improve outcomes in patients with moderate aortic stenosis compared to clinical surveillance?
Design
Review
Authors
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May support re-evaluating moderate AS surveillance; leaves open whether early AVR improves outcomes in randomized trials.
Does aortic valve replacement improve outcomes in patients with moderate aortic stenosis compared to clinical surveillance?
Effect estimate: HR 0.59 (95% CI 0.35 to 0.98)
Absolute Event Rate: 56% vs 67%
p-value: p=0.04
Moderate aortic stenosis is not a benign condition and is associated with significant mortality, prompting re-evaluation of current surveillance guidelines and ongoing trials of early intervention.
Pankayatselvan et al. (2022) studied moderate aortic stenosis (n=3,315). aortic valve replacement (AVR) vs. no intervention was evaluated on 5-year mortality (HR 0.59, 95% CI 0.35 to 0.98, p=0.04). Aortic valve replacement (AVR) reduced 5-year all-cause mortality to 56% for patients with moderate aortic stenosis, compared to 67% mortality in those who did not receive AVR.
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