Outcomes of Early vs Delayed Aortic Valve Replacement: Analysis of the EARLY TAVR Valve Implant Population.

What was studied

This study looked at people with severe aortic stenosis who had no symptoms. It used data from the EARLY TAVR trial. In that trial, people were put by chance into 2 groups. One group got a new heart valve early, through a tube, called TAVR. The other group was watched and got a valve later if needed. This report looked only at people who really got a new valve.

What they found

The trial ran at 75 sites. In the early group, 444 of 455 people got the valve. In the watch group, 388 of 446 got a later valve within 5 years. The typical wait before the later valve was 11.1 months. The main outcome was death, stroke, or a hospital stay for heart failure. This was checked 2 years after the valve was put in. Early TAVR had fewer of these events than a later valve. People whose later valve came after sudden, serious symptoms did worse. Much of this gap came from stroke.

What it means for patients

The authors say a later valve after sudden, serious symptoms was linked to worse results. They say this points to a benefit of early TAVR. They note it is hard to predict when this valve disease will worsen.

Why it is not certain yet

This report compares only people who got a valve, not all people in the trial. So the groups here were not formed purely by chance. The link with sudden symptoms is an association, not proof of cause. The main outcome was checked at 2 years after the valve. The abstract does not give details on side effects or other harms.

Source

Outcomes of Early vs Delayed Aortic Valve Replacement: Analysis of the EARLY TAVR Valve Implant Population.

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