prikaz prve stranice dokumenta Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial
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Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial
Circulation, 145 (2022), 9; 648-658. https://doi.org/10.1161/CIRCULATIONAHA.121.057639
(AVATAR Trial Investigators) Banovic, Marko; Putnik, Svetozar; Penicka, Martin; Doros, Gheorghe; Deja, Marek A.; Kockova, Radka; Kotrc, Martin; Glaveckaite, Sigita; Gašparović, Hrvoje; Pavlović, Nikola; Velicki, Lazar; Salizzoni, Stefano; Wojakowski, Wojtek; Van Camp, Guy; Nikolic, Serge D.; Iung, Bernard; Bartunek, Jozef Više autora...

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Banovic, M., Putnik, S., Penicka, M., Doros, G., Deja, M. A., Kockova, R. ... Bartunek, J. (2022). Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial. Circulation, 145. (9), 648-658. doi: 10.1161/CIRCULATIONAHA.121.057639

Banovic, Marko, et al. "Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial." Circulation, vol. 145, br. 9, 2022, str. 648-658. https://doi.org/10.1161/CIRCULATIONAHA.121.057639

Banovic, Marko, Svetozar Putnik, Martin Penicka, Gheorghe Doros, Marek A. Deja, Radka Kockova, Martin Kotrc, et al. "Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial." Circulation 145, br. 9 (2022): 648-658. https://doi.org/10.1161/CIRCULATIONAHA.121.057639

Banovic, M., et al. (2022) 'Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial', Circulation, 145(9), str. 648-658. doi: 10.1161/CIRCULATIONAHA.121.057639

Banovic M, Putnik S, Penicka M, Doros G, Deja MA, Kockova R, i sur.. Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial. Circulation [Internet]. 03.2022. [pristupljeno 26.12.2024.];145(9):648-658. doi: 10.1161/CIRCULATIONAHA.121.057639

M. Banovic, et al., "Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial", Circulation, vol. 145, br. 9, str. 648-658, Ožujak 2022. [Online]. Dostupno na: https://urn.nsk.hr/urn:nbn:hr:105:007779. [Citirano: 26.12.2024.]

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Naslov (engleski)Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial
AutorMarko Banovic
AutorSvetozar Putnik
AutorMartin Penicka
AutorGheorghe Doros
AutorMarek A. Deja
AutorRadka Kockova
AutorMartin Kotrc
AutorSigita Glaveckaite
AutorHrvoje Gašparović
AutorNikola Pavlović
AutorLazar Velicki
AutorStefano Salizzoni
AutorWojtek Wojakowski
AutorGuy Van Camp
AutorSerge D. Nikolic
AutorBernard Iung
AutorJozef Bartunek
KolaboracijaAVATAR Trial Investigators
Autorova ustanovaSveučilište u Zagrebu
Medicinski fakultet
(KATEDRA ZA KIRURGIJU)
Znanstveno / umjetničko
područje, polje i grana		BIOMEDICINA I ZDRAVSTVO
Kliničke medicinske znanosti
Kirurgija
Sažetak (engleski)
Background: Surgical aortic valve replacement (SAVR) represents a class I indication in symptomatic patients with severe aortic stenosis (AS). However, indications for early SAVR in asymptomatic patients with severe AS and normal left ventricular function remain debated. ------ Methods: The AVATAR trial (Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis) is an investigator-initiated international prospective randomized controlled trial that evaluated the safety and efficacy of early SAVR in the treatment of asymptomatic patients with severe AS, according to common criteria (valve area ≤1 cm2 with aortic jet velocity >4 m/s or a mean transaortic gradient ≥40 mm Hg), and with normal left ventricular function. Negative exercise testing was mandatory for inclusion. The primary hypothesis was that early SAVR would reduce the primary composite end point of all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure compared with a conservative strategy according to guidelines. The trial was designed as event-driven to reach a minimum of 35 prespecified events. The study was performed in 9 centers in 7 European countries. ------ Results: Between June 2015 and September 2020, 157 patients (mean age, 67 years; 57% men) were randomly allocated to early surgery (n=78) or conservative treatment (n=79). Follow-up was completed in May 2021. Overall median follow-up was 32 months: 28 months in the early surgery group and 35 months in the conservative treatment group. There was a total of 39 events, 13 in early surgery and 26 in the conservative treatment group. In the early surgery group, 72 patients (92.3%) underwent SAVR with operative mortality of 1.4%. In an intention-to-treat analysis, patients randomized to early surgery had a significantly lower incidence of primary composite end point than those in the conservative arm (hazard ratio, 0.46 [95% CI, 0.23-0.90]; P=0.02). There was no statistical difference in secondary end points, including all-cause mortality, first heart failure hospitalizations, major bleeding, or thromboembolic complications, but trends were consistent with the primary outcome. ----- Conclusions: In asymptomatic patients with severe AS, early surgery reduced a primary composite of all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure compared with conservative treatment. This randomized trial provides preliminary support for early SAVR once AS becomes severe, regardless of symptoms.
Ključne riječi (engleski)
Jezikengleski
Vrsta publikacijeZnanstveni rad - Izvorni znanstveni rad
Status objaveObjavljen
Vrsta recenzijeRecenziran
Verzija publikacijeObjavljena verzija rada (izdavačev PDF)
Naslov časopisaCirculation
Brojčani podacivol. 145, br. 9, str. 648-658
p-ISSN0009-7322
e-ISSN1524-4539
DOIhttps://doi.org/10.1161/CIRCULATIONAHA.121.057639
URN:NBNurn:nbn:hr:105:007779
Datum objave publikacije2022-03
URL dokumentahttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639
Vrsta resursaTekst
Prava pristupaOtvoreni pristup
Uvjeti korištenjaIkona licence Imenovanje 4.0 međunarodna (CC BY 4.0)
Datum i vrijeme pohrane2022-03-10 10:15:42