Valvular & structural heart disease
Early Intervention vs Conservative Management in Severe Asymptomatic Aortic Stenosis: A Critical Review of Randomized Evidence
Authors' conclusion
Current evidence supports a tailored approach: conservative management is reasonable when reliable follow-up can be ensured, while early aortic valve replacement may benefit selected patients.
Study context
- Population
- Asymptomatic severe aortic stenosis (AS)4 RCTs
- Comparison
- Early AVR vs conservative management
Primary result
As reported in the abstract
Composite:
- Endpoints involving HF hospitalization
- Mortality
- Stroke
- SCD
- Early intervention reduces composite endpoints involving HF hospitalization
- Individual trials have not demonstrated consistent mortality or stroke benefits
- SCD rare across all trials
- 4 RCTs: AVATAR, RECOVERY, EARLY TAVR, EVOLVED
Original publication
Early Intervention vs Conservative Management in Severe Asymptomatic Aortic Stenosis: A Critical Review of Randomized Evidence. JACC Adv. Published 19 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it