Early aortic valve replacement in asymptomatic severe aortic stenosis with preserved ejection fraction

Abstract Background Aortic stenosis (AS) is the most common valvular disease in developed countries. Specific timing of intervention for asymptomatic patients with severe aortic and preserved ejection fraction remains controversial. Purpose To compare outcomes early valve replacement (AVR) versus watchful waiting (WW) AS ejection. Methods We systematically searched PubMed, Embase Cochrane databases, November 2021, both interventional or observational studies comparing early-AVR WW treatment severeAS criteria. Random-effects meta-analysis was performed. Results Eight were included which two randomized clinical trials. A total 2672 included, providing a 642 pooled death events (327 941 waiting). In our meta-analysis, revealed significant lower all-cause mortality (pooled OR, 0.39; 95% CI [0.30, 0.51], P<0.01; I2=47%). Additionally, group presented rate cardiovascular 0.33; [0.19, 0.56], I2=64%). Both strategies had similar stroke 1.30; [0.39, 4.27], P=0.67; I2=0%) myocardial infarction 0.49; [0.14, 1.78], P=0.28; I2=0%). Heart Failure hospitalizations trend 0.22; [0.05, 1.08], P=0.36; I2=36%). Conclusion Our data suggests that strategy preferable fraction. Funding Acknowledgement Type funding sources: None.