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Safety and feasibility of robotic percutaneous coronary intervention: PRECISE (Percutaneous Robotically-Enhanced Coronary Intervention) Study Influence of LDL-Cholesterol Lowering on Cardiovascular Outcomes in Patients With Diabetes Mellitus Undergoing Coronary Revascularization Comparative Accuracy of Focused Cardiac Ultrasonography and Clinical Examination for Left Ventricular Dysfunction and Valvular Heart Disease: A Systematic Review and Meta-analysis Cardiorespiratory Fitness and Mortality in Healthy Men and Women The optimal duration of dual antiplatelet therapy after coronary stent implantation: to go too far is as bad as to fall short Cholesterol-Lowering Agents Utilization and programming of an automatic MRI recognition feature for cardiac rhythm management devices Impact of Statins on Cardiovascular Outcomes Following Coronary Artery Calcium Scoring Short-term and long-term clinical outcomes of rotational atherectomy in resistant chronic total occlusion Causes, Timing, and Impact of Dual Antiplatelet Therapy Interruption for Surgery (from the Patterns of Non-adherence to Anti-platelet Regimens In Stented Patients Registry)

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 . . .