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Early Intervention May Be Better for Severe Asymptomatic Aortic Stenosis

FRIDAY, May 20, 2022 -- For patients with severe asymptomatic aortic stenosis, early intervention may reduce the risk for all-cause mortality compared with conservative management, according to a systematic review and meta-analysis published online May 17 in Open Heart.

Vasiliki Tsampasian, M.D., from Norfolk and Norwich University Hospital in the United Kingdom, and colleagues conducted a systematic review and meta-analysis to examine data relating to the management of severe asymptomatic aortic stenosis. The strategies of early intervention and conservative management were compared.

The researchers found that based on a meta-analysis of data from two published randomized trials, including 302 patients, early intervention resulted in a significant reduction in all-cause mortality and in the risk for hospitalization for heart failure. No difference was seen between the groups in terms of risk for cardiovascular death. Patients treated with early intervention demonstrated improved mortality in a meta-analysis of data from eight observational studies.

"This meta-analysis shows that the data from the two recent large randomized controlled trials and previous observational studies demonstrate a favorable outcome in the group of patients treated with early intervention rather than conservative management," the authors write. "Although this may herald the beginning of a change in the management of these patients, further randomized controlled studies are needed to draw firm conclusions and identify the optimal timing of intervention."

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