Heart failure & cardiomyopathiesRandomised controlled trial
Transcatheter Aortic Valve Replacement in Patients With Systolic Heart Failure and Moderate Aortic Stenosis
- Randomised controlled trial
- investigator-initiated
- international
- 1:1 randomisation
Authors' conclusion
TAVR was not superior to AS surveillance for the primary hierarchical composite endpoint in patients with moderate AS and HFrEF on GDMT.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) on guideline-directed medical therapy (GDMT) with moderate aortic stenosis (AS) suitable for transfemoral TAVRmedian follow-up 23 months
- Participants
- 178 patients
- Comparison
- TAVR vs clinical AS surveillance
- TAVRn = 89
- Clinical aortic stenosis surveillance (CASS)n = 89reference
- Primary endpoint
- Hierarchical composite of:
- All-cause death
- Disabling stroke
- Disease-related hospitalizations and HF equivalents
- Change from baseline in KCCQ Overall Summary Score
Primary result
As reported in the abstract
Win ratio
1.31
95% CI 0.91–1.88
P = 0.14
By group
TAVR vs CASS
win ratio 1.31 (95% CI 0.91–1.88); P = 0.14
Further findings
Change in KCCQ Overall Summary Score · 1 year
P = 0.018
| Outcome | TAVR | CASS | P value |
|---|---|---|---|
| Crossover to TAVR in CASS · median 12 months postrandomization | Not reported in the abstract | 43% |
- Crossover to TAVR in CASS: 35 had progressed to severe AS
Original publication
Transcatheter Aortic Valve Replacement in Patients With Systolic Heart Failure and Moderate Aortic Stenosis. J Am Coll Cardiol. Published 28 October 2024. doi:10.1016/j.jacc.2024.10.070
Summarised from the published abstract; every number is checked against it