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Association of Left Ventricular Systolic Function With Incident Heart Failure in Late Life Ambulatory Inotrope Infusions in Advanced Heart Failure - A Systematic Review and Meta-Analysis Risk of Mortality Following Catheter Ablation of Atrial Fibrillation Imaging- and physiology-guided percutaneous coronary intervention without contrast administration in advanced renal failure: a feasibility, safety, and outcome study Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) Late kidney injury after transcatheter aortic valve replacement Heart Failure With Mid-Range (Borderline) Ejection Fraction: Clinical Implications and Future Directions Heart Failure Outcomes With Volume-Guided Management Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes

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 . . .