Valvular & structural heart diseaseRandomised controlled trial
Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis at 10 Years
- Randomised controlled trial
- 1:1 randomisation
Authors' conclusion
Among asymptomatic patients with very severe aortic stenosis, early surgery led to a lower risk of a composite of operative mortality or death from cardiovascular causes than conservative care at 10 years.
Study context
- Population
- Asymptomatic patients with very severe AS (aortic-valve area ≤0.75 cm² with peak aortic jet velocity ≥4.5 m per second)
- Participants
- 145 patients
- Comparison
- Early surgery vs conservative care
- Early surgeryn = 73
- Conservative caren = 72reference
- Primary endpoint
- Composite of:
- Operative mortality
- Death from CV causes
- Follow-up
- 10-year follow-up
Primary result
As reported in the abstract
Hazard ratio
0.10
95% CI 0.02–0.43
P = 0.002
Events by treatment group
Early surgery vs Conservative care
HR 0.10 (95% CI 0.02–0.43); P = 0.002
Further findings
Cumulative incidence of operative mortality or CV death · 10 years
| Outcome | Early surgery | Conservative care | HR (95% CI) | |
|---|---|---|---|---|
| All-cause death | 15% | 32% | 0.42 (0.21–0.86) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis at 10 Years. N Engl J Med. Published 26 March 2026. doi:10.1056/nejmoa2511920
Summarised from the published abstract; every number is checked against it