{"id":6941,"date":"2025-05-22T12:20:08","date_gmt":"2025-05-22T09:20:08","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=6941"},"modified":"2025-05-22T12:20:08","modified_gmt":"2025-05-22T09:20:08","slug":"early-tavr-trial-sends-clear-message-dont-wait","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/early-tavr-trial-sends-clear-message-dont-wait\/","title":{"rendered":"EARLY TAVR Trial Sends Clear Message: \u201cDon\u2019t Wait\u201d!"},"content":{"rendered":"
EARLY TAVR Trial Sends Clear Message: \u201cDon\u2019t Wait\u201d!<\/div>\n
New TAVR Data Challenges the Wait-and-See policy-<\/div>\n
(\u201cwatchful waiting\u201d or clinical monitoring):<\/div>\n
<\/div>\n
EARLY TAVR Trial Highlights \u2013 Published May 1, 2025<\/div>\n
Presented at ACC.25<\/div>\n
<\/div>\n
1. Early TAVR in asymptomatic severe aortic stenosis (AS) patients leads to significantly better outcomes than waiting for symptoms to appear.<\/span><\/div>\n
2. Among patients who followed a \u201cwait-for-symptoms\u201d strategy, 40% deteriorated rapidly and unpredictably. These patients often presented with:<\/span><\/div>\n
\u2022 Sudden cardiac arrest<\/span><\/div>\n
\u2022 Acute heart failure or pulmonary edema<\/span><\/div>\n
\u2022 Significantly higher stroke rates<\/span><\/div>\n
3. Delayed intervention resulted in worse clinical outcomes, including:<\/span><\/div>\n
\u2022 Increased mortality<\/span><\/div>\n
\u2022 More unplanned hospitalizations<\/span><\/div>\n
\u2022 Higher post-TAVR instability and complications<\/span><\/div>\n
4. The trial enrolled ~900 asymptomatic patients, split between early TAVR and standard monitoring. Long-term data confirmed that early TAVR outperformed symptom-guided timing across all major endpoints.<\/span><\/div>\n
5. Waiting can be dangerous:<\/span><\/div>\n
\u2022 \u201cCrash and burn\u201d patients progressed from stable to critically ill within months.<\/span><\/div>\n
\u2022 Once symptomatic, these patients were harder to treat, and less likely to recover fully.<\/span><\/div>\n
6. Risk prediction during watchful waiting is unreliable:<\/span><\/div>\n
\u2022 Conventional tools (valve velocity, LVEF, stress testing) failed to identify which patients would suddenly deteriorate.<\/span><\/div>\n
\u2022 Many patients appeared stable until they weren\u2019t.<\/span><\/div>\n
7. Stroke risk nearly doubled in the delayed group, particularly after 2 years. Severe AS may independently contribute to stroke through mechanisms such as:<\/span><\/div>\n
\u2022 Progressive valve calcification<\/span><\/div>\n
\u2022 Occult atrial fibrillation<\/span><\/div>\n
\u2022 Inflammatory and thrombotic changes<\/span><\/div>\n
8. Dr. Philippe Genereux, the principal investigator, emphasized:<\/span><\/div>\n
\u201cYou can\u2019t predict who will crash. That\u2019s why waiting is a gamble\u2014with 40% odds of serious decline.\u201d<\/div>\n
He added: \u201cIt\u2019s time to change the guidelines and act earlier.\u201d<\/div>\n
9. These findings helped support the FDA\u2019s May 1, 2025 approval of the Edwards Sapien 3 valve for asymptomatic severe AS patients, marking a shift in how early disease is managed.<\/span><\/div>\n
<\/div>\n
Link :<\/div>\n
https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2405880<\/a><\/div>\n
Article: Latest EARLY TAVR data suggest it is time to update industry guidelines<\/div>\n","protected":false},"excerpt":{"rendered":"

EARLY TAVR Trial Sends Clear Message: \u201cDon\u2019t Wait\u201d! New TAVR Data Challenges the Wait-and-See policy- (\u201cwatchful waiting\u201d or clinical monitoring): EARLY TAVR Trial Highlights \u2013 Published May 1, 2025 Presented at ACC.25 1. Early TAVR in asymptomatic severe aortic stenosis (AS) patients leads to significantly better outcomes than waiting for symptoms to appear. 2. Among […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6941","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6941","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=6941"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6941\/revisions"}],"predecessor-version":[{"id":6942,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6941\/revisions\/6942"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=6941"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=6941"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=6941"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}