Key result
Evolut PRO shows similar 1-year major events versus SAPIEN 3 Ultra but higher disabling stroke rates.
Why the study?
Midterm comparative analyses of the latest iterations of the most used Evolut and SAPIEN platforms for TAVI are lacking.
Does the Evolut PRO/PRO+ device reduce the composite of 1-year all-cause death, disabling stroke and rehospitalisation for heart failure compared to the SAPIEN 3 Ultra device in patients undergoing transfemoral TAVI?
Cohort
Does the Evolut PRO/PRO+ device reduce the composite of 1-year all-cause death, disabling stroke and rehospitalisation for heart failure compared to the SAPIEN 3 Ultra device in patients undergoing transfemoral TAVI?
p-value: p=>0.10
The latest iterations of self-expanding and balloon-expandable TAVI devices show similar 1-year composite clinical outcomes in real-world practice, although self-expanding devices may be associated with a higher risk of disabling stroke.
May reassure on PRO/ULTRA interchangeability in TAVI practice; leaves randomized confirmation open.
BACKGROUND: Midterm comparative analyses of the latest iterations of the most used Evolut and SAPIEN platforms for transcatheter aortic valve implantation (TAVI) are lacking. AIMS: We aimed to compare 1-year clinical outcomes of TAVI patients receiving Evolut PRO/PRO+ (PRO) or SAPIEN 3 Ultra (ULTRA) devices in current real-world practice. METHODS: Among patients enrolled in the OPERA-TAVI registry, patients with complete 1-year follow-up were considered for the purpose of this analysis. One-to-one propensity score matching was used to compare TAVI patients receiving PRO or ULTRA devices. The primary endpoint was a composite of 1-year all-cause death, disabling stroke and rehospitalisation for heart failure. Five prespecified subgroups of patients were considered according to leaflet and left ventricular outflow tract calcifications, annulus dimensions and angulation, and leaflet morphology. RESULTS: >0.10). CONCLUSIONS: One-year clinical outcomes of patients undergoing transfemoral TAVI and receiving PRO or ULTRA devices in the current clinical practice were similar, but PRO patients had higher rates of disabling stroke. Outcomes did not differ across the different anatomical subsets of the aortic root.
No takes yet. Share an insight, caveat, or question.
Costa et al. (2023) conducted a cohort in Transcatheter aortic valve implantation. Evolut PRO/PRO+ vs. SAPIEN 3 Ultra was evaluated on Composite of 1-year all-cause death, disabling stroke and rehospitalisation for heart failure (p=>0.10). Evolut PRO/PRO+ and SAPIEN 3 Ultra devices showed similar 1-year rates of death, disabling stroke, and heart failure rehospitalization (P>0.10), though PRO had higher disabling stroke rates.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: