Valvular & structural heart diseaseMeta-analysis
Transcatheter vs Surgical Aortic Valve Replacement in Lower-Risk Patients
- Systematic review and meta-analysis of randomised trials
- reconstructed time-to-event individual participant data (IPD)
- pooled survival analyses
- Weighted mean follow-up 35.7 months
Authors' conclusion
In lower-risk patients, TAVR was associated with a reduced hazard of death and death or disabling stroke compared with SAVR, while rates of stroke were equivalent.
Study context
- Population
- Lower-risk patients with severe AS
- Participants
- 5,341 patients · 6 RCTs
- Comparison
- Transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR)
- TAVRn = 2,717
- SAVRn = 2,624reference
- Outcome
- All-cause death
- Follow-up
- 5 years
Pooled result
As reported in the abstract
Hazard ratio
0.80
95% CI 0.66–0.97
P = 0.02
TAVR vs SAVR
HR 0.80 (95% CI 0.66–0.97); P = 0.02
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause death or disabling stroke · 5 years · 19% reduction in hazard · pooled survival analyses of reconstructed time-to-event IPD | 0.81 (0.68–0.96) | P = 0.01 | |
| 0.512Hazard ratio (log scale) |
Stroke
- No difference in stroke (HR: 0.97; 95% CI: 0.74-1.26)
- P = 0.80
Original publication
Transcatheter vs Surgical Aortic Valve Replacement in Lower-Risk Patients. J Am Coll Cardiol. Published 11 March 2025. doi:10.1016/j.jacc.2024.12.031
Summarised from the published abstract; every number is checked against it