The long-term outcomes of asymptomatic severe aortic stenosis patients may be significantly improved by an initial aortic valve replacement (AVR) strategy, according to the results of the CURRENT AS Registry trial, presented Oct. 15 at TCT 2015 and simultaneously published in the Journal of the American College of Cardiology.

Tomohiko Taniguchi, MD, et al., divided 1808 asymptomatic patients with severe aortic stenosis between initial AVR (n=291) and conservative strategies (n=1517) to compare the long-term outcomes in both. The average follow-up period was 1361 days, with a 90 percent follow-up at the 2-year mark.

The results of the study showed that incidences of all-cause death and heart failure hospitalization were substantially lower in the initial AVR group at five-year follow-up, compared to the conservative strategy group (15.4 vs. 26.4 percent, respectively). Further, the patients receiving initial AVR had lower five-year follow-up incidences of cardiovascular death and aortic valve-related death (9.9 vs. 18.6 percent in the conservative group).

According to the authors of the study, “41 percent of patients managed conservatively required AVR within a median follow-up of two years, suggesting that one does not gain much by waiting.”

They add that “AVR during the asymptomatic phase might be a viable treatment option in severe aortic stenosis patients at low-risk for AVR.”

Keywords: Transcatheter Cardiovascular Therapeutics, Aortic Valve, Aortic Valve Stenosis, Registries, Cause of Death, Heart Failure, Heart Valve Prosthesis, Hospitalization

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