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Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement

Jørgensen, Troels Højsgaard ; Thyregod, Hans Gustav Hørsted ; Ihlemann, Nikolaj ; Nissen, Henrik ; Petursson, Petur ; Kjeldsen, Bo Juel ; Steinbrüchel, Daniel Andreas ; Olsen, Peter Skov ; Søndergaard, Lars

European heart journal, 2021-08, Vol.42 (30), p.2912-2919 [Periódico revisado por pares]

Oxford University Press

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  • Título:
    Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement
  • Autor: Jørgensen, Troels Højsgaard ; Thyregod, Hans Gustav Hørsted ; Ihlemann, Nikolaj ; Nissen, Henrik ; Petursson, Petur ; Kjeldsen, Bo Juel ; Steinbrüchel, Daniel Andreas ; Olsen, Peter Skov ; Søndergaard, Lars
  • Assuntos: Cardiac and Cardiovascular Systems ; Clinical Research ; Editor's Choice ; Kardiologi
  • É parte de: European heart journal, 2021-08, Vol.42 (30), p.2912-2919
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
    ObjectType-News-1
    ObjectType-Feature-3
    content type line 23
    Troels Højsgaard Jørgensen and Hans Gustav Hørsted Thyregod authors shared first authorship.
  • Descrição: Abstract Aims The aims of the study were to compare clinical outcomes and valve durability after 8 years of follow-up in patients with symptomatic severe aortic valve stenosis at low surgical risk treated with either transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Methods and results In the NOTION trial, patients with symptomatic severe aortic valve stenosis were randomized to TAVI or SAVR. Clinical status, echocardiography, structural valve deterioration, and failure were assessed using standardized definitions. In total, 280 patients were randomized to TAVI (n = 145) or SAVR (n = 135). Baseline characteristics were similar, including mean age of 79.1 ± 4.8 years and a mean STS score of 3.0 ± 1.7%. At 8-year follow-up, the estimated risk of the composite outcome of all-cause mortality, stroke, or myocardial infarction was 54.5% after TAVI and 54.8% after SAVR (P = 0.94). The estimated risks for all-cause mortality (51.8% vs. 52.6%; P = 0.90), stroke (8.3% vs. 9.1%; P = 0.90), or myocardial infarction (6.2% vs. 3.8%; P = 0.33) were similar after TAVI and SAVR. The risk of structural valve deterioration was lower after TAVI than after SAVR (13.9% vs. 28.3%; P = 0.0017), whereas the risk of bioprosthetic valve failure was similar (8.7% vs. 10.5%; P = 0.61). Conclusions In patients with severe aortic valve stenosis at low surgical risk randomized to TAVI or SAVR, there were no significant differences in the risk for all-cause mortality, stroke, or myocardial infarction, as well as the risk of bioprosthetic valve failure after 8 years of follow-up. Clinical trial registration URL: http://www.ClinicalTrials.gov. Unique identifier: NCT01057173. Graphical Abstract Clinical and aortic bioprosthetic valve failure 8 years after transcatheter and surgical aortic valve replacement. CI, confidence interval; HR, hazard ratio.
  • Editor: Oxford University Press
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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