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Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality Assessment of Vascular Dysfunction in Patients Without Obstructive Coronary Artery Disease: Why, How, and When Temporal Trends, Characteristics, and Outcomes of Infective Endocarditis After Transcatheter Aortic Valve Replacement 6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial Higher neutrophil-to-lymphocyte ratio (NLR) increases the risk of suboptimal platelet inhibition and major cardiovascular ischemic events among ACS patients receiving dual antiplatelet therapy with ticagrelor Impact of Percutaneous Revascularization on Exercise Hemodynamics in Patients With Stable Coronary Disease Ambulatory Electrocardiogram Monitoring in Patients Undergoing Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review Dual Antiplatelet TherapyIs It Time to Cut the Cord With Aspirin? Infective Endocarditis After Transcatheter Aortic Valve Replacement New-onset atrial fibrillation after PCI and CABG for left main disease: insights from the EXCEL trial and additional studies

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 . . .