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Association of the PHACTR1/EDN1 Genetic Locus With Spontaneous Coronary Artery Dissection Long-Term Incremental Prognostic Value of Cardiovascular Magnetic Resonance After ST-Segment Elevation Myocardial Infarction A Study of the Collaborative Registry on CMR in STEMI Oxidative Stress and Cardiovascular Risk: Obesity, Diabetes, Smoking, and Pollution: Part 3 of a 3-Part Series MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction-DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy Preventing Coronary Obstruction During Transcatheter Aortic Valve Replacement From Computed Tomography to BASILICA The Aging Cardiovascular System: Understanding It at the Cellular and Clinical Levels Randomized Trial Evaluating Percutaneous Coronary Intervention for the Treatment of Chronic Total Occlusion: The DECISION-CTO Trial Impact of Off-Hours Versus On-Hours Primary Percutaneous Coronary Intervention on Myocardial Damage and Clinical Outcomes in ST-Segment Elevation Myocardial Infarction Late Survival Benefit of Percutaneous Coronary Intervention Compared With Medical Therapy in Patients With Coronary Chronic Total Occlusion: A 10-Year Follow-Up Study Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions
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EditorialNovember 16, 2019

JOURNAL：N Engl J Med. Article Link

Timing of Intervention in Aortic Stenosis

P Lancellotti, MA Vannan. Keywords: asymptomatic patients with severe aortic stenosis; treatment timing

ABSTRACT

Current guidelines require that in patients with severe aortic stenosis, symptoms related to the valvular disease be present for consideration of transcatheter aortic-valve replacement (TAVR) or surgical aortic-valve replacement.  In the absence of symptoms, only very severe aortic stenosis is an indication (class IIa) for intervention. Kang et al. now report in the Journal the results of a trial involving patients with asymptomatic, very severe aortic stenosis who were randomly assigned to surgical aortic-valve replacement or conservative care (clinical follow-up and observation). Outcomes (death during or within 30 days after surgery [operative mortality] or death from cardiovascular causes; death from . . .

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