Outcomes of Transcatheter Aortic Valve Replacement in Asymptomatic or Minimally Symptomatic Aortic Stenosis

doi:10.1016/j.jcin.2023.07.007

Valvular & structural heart diseaseCohort study

Outcomes of Transcatheter Aortic Valve Replacement in Asymptomatic or Minimally Symptomatic Aortic Stenosis

JACC Cardiovasc IntervPublished 20 Sep 2023

Registry-based cohort study
STS/ACC TVT registry

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Authors' conclusion

Although minimally symptomatic patients treated with TAVR experience only small improvements in health status, their overall outcomes are favorable with a higher likelihood of survival with good health status at 1 year compared with more symptomatic patients.

Study context

Population: Patients with severe AS and normal LVEF undergoing transcatheter aortic valve replacement (TAVR), 2015–202120.0% minimally symptomatic
Participants: 231,285 patients

Exposure: Minimally symptomatic vs moderate or severe symptoms before TAVR

Main finding

Death · 1 year

Adjusted hazard ratio

0.70

95% CI 0.66–0.75

Minimally symptomatic vs Moderate or severe symptoms

adjusted HR 0.70 (95% CI 0.66–0.75)

As reported in the abstract

Observational data: associations, not effects.

Further findings

Change in mean KCCQ-OS · 30 days

Minimally symptomaticmean increase 2.7 points95% CI 2.6–2.9

Moderate or severe symptomsmean increase 32.2 points95% CI 32.0–32.3

Change in mean KCCQ-OS · 1 year

Minimally symptomaticmean increase 3.8 points95% CI 3.6–4.0

Moderate or severe symptomsmean increase 34.9 points95% CI 34.7–35.0

Outcome		OR (95% CI)
Alive and well · 1 year		1.19 (1.16–1.23)
	0.512Odds ratio (log scale)

Original publication

Outcomes of Transcatheter Aortic Valve Replacement in Asymptomatic or Minimally Symptomatic Aortic Stenosis. JACC Cardiovasc Interv. Published 20 September 2023. doi:10.1016/j.jcin.2023.07.007

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Summarised from the published abstract; every number is checked against it