Age and Procedural Timing for Asymptomatic Severe Aortic Stenosis: Analysis From the EARLY TAVR Trial
Recommended Citation
Goel K, Lindman BR, Schwartz A, Cohen DJ, Giustino G, Oldemeyer JB, Strote J, Babaliaros V, Devireddy CM, Fischbein MP, Fearon WF, Daniels D, Spies C, Chhatriwalla AK, Suradi HS, Shah P, Szerlip M, Dahle T, Apostolou D, Makkar R, Davidson CJ, Sheth T, Sorajja P, DeVries JT, Southard J, Depta JP, Pop A, Rinaldi MJ, Badr S, Williams MR, Russo MJ, Guerrero M, McCabe JM, Pibarot P, Wang Y, Leon MB, Généreux P. Age and Procedural Timing for Asymptomatic Severe Aortic Stenosis: Analysis From the EARLY TAVR Trial. Circ Cardiovasc Interv. 2026;19(8):e016370.
Document Type
Article
Publication Date
8-1-2026
Publication Title
Circ Cardiovasc Interv
Keywords
Humans, Aortic Valve Stenosis, Female, Male, Aged, 80 and over, Aged, Time Factors, Age Factors, Treatment Outcome, Severity of Illness Index, Risk Factors, Stroke, Asymptomatic Diseases, Heart Failure, Transcatheter Aortic Valve Replacement, Aortic Valve, Hospitalization
Abstract
BACKGROUND: The EARLY TAVR trial (Evaluation of TAVR Compared to Surveillance for Patients with Asymptomatic Severe Aortic Stenosis) demonstrated that early transcatheter aortic valve replacement (TAVR) was superior to clinical surveillance (CS) in asymptomatic severe aortic stenosis. The relative impact of early TAVR versus CS strategy by age is unknown.
METHODS: The study population of the EARLY TAVR trial was stratified into 4 age groups: 65 to 69 years (n=141), 70 to 74 years (n=263), 75 to 79 years (n=250), and ≥80 years (n=247). Associations between age and the trial primary end point of death, stroke, or unplanned cardiovascular hospitalization; the composite end point of death, stroke, or heart failure hospitalization; and its individual components were examined. Interaction tests evaluated whether the treatment effect of early TAVR versus CS differed by age.
RESULTS: No interaction was detected between age and the treatment effect of early TAVR versus CS for the composites or individual outcomes. We observed lower stroke rates with early TAVR compared with CS in the youngest (65-69 years, absolute risk reduction, 13%;
CONCLUSIONS: In the EARLY TAVR trial, the relative benefit of early TAVR over CS was consistent among all age groups. The greatest absolute reduction in stroke rate with early TAVR compared with CS appeared in the youngest and oldest groups, whereas reduction in heart failure hospitalization was most pronounced in the oldest patients. These data suggest that early TAVR should be considered in all age groups above 65 years.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03042104.
Medical Subject Headings
Humans; Aortic Valve Stenosis; Female; Male; Aged, 80 and over; Aged; Time Factors; Age Factors; Treatment Outcome; Severity of Illness Index; Risk Factors; Stroke; Asymptomatic Diseases; Heart Failure; Transcatheter Aortic Valve Replacement; Aortic Valve; Hospitalization
PubMed ID
42233211
Volume
19
Issue
8
First Page
016370
Last Page
016370
