Valvular & structural heart disease

Treadmill Stress Test in Patients With Asymptomatic Severe Aortic Stenosis: A Prespecified Registry-Based Follow-Up of the EARLY TAVR Randomized Clinical Trial

JAMA CardiolPublished Prospective registry study

Authors' conclusion

In patients with asymptomatic severe AS, TST was found to be safe and identified symptoms and AVR indication in approximately 15% of patients. However, 20% of those patients remained untreated at 1 year, despite having an indication for prompt treatment.

Study context

Population
Apparently asymptomatic patients with severe aortic stenosis (AS) screened for EARLY TAVR with a positive treadmill stress testing (TST), US, 2017–2021146 positive TST of 962 eligible
Participants
105 patients
Outcome
TST-related safety, all-cause mortality and rates of subsequent AVR
Follow-up
2 years
Methodological detailsprespecified TST registry of the EARLY TAVR randomised trial, multicentre, 75 US sites
  • Prespecified TST registry of the EARLY TAVR randomised trial
  • Multicentre
  • 75 US sites

Main finding

As reported in the abstract

2-year Kaplan-Meier all-cause mortality

5.7%

Aortic valve replacement (AVR) at 1 year (positive TST)

79.9%

AVR at 2 years (positive TST)

85.9%

Observational data: associations, not effects.

Further findings

Positive TST among those meeting trial criteria

Multivariable baseline predictors of a positive TST

Higher peak velocity, lower EF, prior CABG and prior stroke

Safety

TST-related safety

No reported deaths, syncope or cardioversions

Original publication

Treadmill Stress Test in Patients With Asymptomatic Severe Aortic Stenosis: A Prespecified Registry-Based Follow-Up of the EARLY TAVR Randomized Clinical Trial. JAMA Cardiol. Published 1 September 2026. doi:10.1001/jamacardio.2026.2527

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

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