Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Banovic M, Iung B, Wojakowski W, Van Mieghem N, Bartunek J. Asymptomatic Severe and Moderate Aortic Stenosis: Time for Appraisal of Treatment Indications. Struct Heart 2023;7:100201. [PMID: 37745683 PMCID: PMC10512009 DOI: 10.1016/j.shj.2023.100201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 09/26/2023]

For:	Banovic M, Iung B, Wojakowski W, Van Mieghem N, Bartunek J. Asymptomatic Severe and Moderate Aortic Stenosis: Time for Appraisal of Treatment Indications. Struct Heart 2023;7:100201. [PMID: 37745683 PMCID: PMC10512009 DOI: 10.1016/j.shj.2023.100201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 09/26/2023]

Number

Cited by Other Article(s)

Banovic M, Putnik S, Da Costa BR, Penicka M, Deja MA, Kotrc M, Kockova R, Glaveckaite S, Gasparovic H, Pavlovic N, Velicki L, Salizzoni S, Wojakowski W, Van Camp G, Gradinac S, Laufer M, Tomovic S, Busic I, Bojanic M, Ristic A, Klasnja A, Matkovic M, Boskovic N, Zivic K, Jovanovic M, Nikolic SD, Iung B, Bartunek J. Aortic valve replacement vs. conservative treatment in asymptomatic severe aortic stenosis: long-term follow-up of the AVATAR trial. Eur Heart J 2024;45:4526-4535. [PMID: 39217448 DOI: 10.1093/eurheartj/ehae585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 07/31/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open

Abstract

BACKGROUND AND AIMS

The question of when and how to treat truly asymptomatic patients with severe aortic stenosis (AS) and normal left ventricular (LV) systolic function is still subject to debate and ongoing research. Here, the results of extended follow-up of the AVATAR trial are reported (NCT02436655, ClinicalTrials.gov).

METHODS

The AVATAR trial randomly assigned patients with severe, asymptomatic AS and LV ejection fraction ≥ 50% to undergo either early surgical aortic valve replacement (AVR) or conservative treatment with watchful waiting strategy. All patients had negative exercise stress testing. The primary hypothesis was that early AVR will reduce a primary composite endpoint comprising all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure (HF), as compared with conservative treatment strategy.

RESULTS

A total of 157 low-risk patients (mean age 67 years, 57% men, mean Society of Thoracic Surgeons score 1.7%) were randomly allocated to either the early AVR group (n = 78) or the conservative treatment group (n = 79). In an intention-to-treat analysis, after a median follow-up of 63 months, the primary composite endpoint outcome event occurred in 18/78 patients (23.1%) in the early surgery group and in 37/79 patients (46.8%) in the conservative treatment group [hazard ratio (HR) early surgery vs. conservative treatment 0.42; 95% confidence interval (CI) 0.24-0.73, P = .002]. The Kaplan-Meier estimates for individual endpoints of all-cause death and HF hospitalization were significantly lower in the early surgery compared with the conservative group (HR 0.44; 95% CI 0.23-0.85, P = .012, for all-cause death and HR 0.21; 95% CI 0.06-0.73, P = .007, for HF hospitalizations).

CONCLUSIONS

The extended follow-up of the AVATAR trial demonstrates better clinical outcomes with early surgical AVR in truly asymptomatic patients with severe AS and normal LV ejection fraction compared with patients treated with conservative management on watchful waiting.

Collapse

Affiliation(s)

Marko Banovic Belgrade Medical School, University of Belgrade, Serbia Cardiology Department, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
Svetozar Putnik Belgrade Medical School, University of Belgrade, Serbia Cardiac-Surgery Department, University Clinical Center of Serbia, Belgrade, Serbia
Bruno R Da Costa Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Martin Penicka Cardiovascular Center, OLV Hospital, Aalst, Belgium
Marek A Deja Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
Martin Kotrc Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
Radka Kockova Faculty of Medicine Hradec Králové, Charles University, Hradec Kralove, Czech Republic
Sigita Glaveckaite Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
Hrvoje Gasparovic Department of Cardiac Surgery, University of Zagreb School of Medicine and University Hospital Center Zagreb, Zagreb, Croatia
Nikola Pavlovic Department of Cardiology, University Hospital Dubrava, Zagreb, Croatia
Lazar Velicki Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia Department of Cardiac Surgery, Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia
Stefano Salizzoni Division of Cardiac Surgery, Cardiovascular and Thoracic Department, University of Turin, Turin, Italy
Wojtek Wojakowski Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
Guy Van Camp Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Sinisa Gradinac Sabah Al Ahmad Cardiac Center, Amiri Hospital, Kuwait City, Kuwait
Michael Laufer Mach Ventures, Menlo Park, CA, USA
Sara Tomovic Belgrade Medical School, University of Belgrade, Serbia
Ivan Busic Belgrade Medical School, University of Belgrade, Serbia
Milica Bojanic Anesteziology Department, 'Institute Banjica', Belgrade, Serbia
Arsen Ristic Belgrade Medical School, University of Belgrade, Serbia Cardiology Department, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
Andrea Klasnja Department of Cardiology, University Clinical Center 'Bezanijska Kosa', Belgrade, Serbia
Milos Matkovic Belgrade Medical School, University of Belgrade, Serbia Cardiac-Surgery Department, University Clinical Center of Serbia, Belgrade, Serbia
Nikola Boskovic Cardiology Department, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
Katarina Zivic Cardiology Department, University Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia
Miodrag Jovanovic Department of Internal Medicine, General Hospital 'Pozarevac', Pozarevac, Serbia
Serge D Nikolic CorDynamix, Redwood City, CA, USA
Bernard Iung Cardiology Department, Bichat Hospital APHP and Universite Paris-Cité, Paris, France
Jozef Bartunek Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK

Collapse

Fontana F, Piacentino F, Gnesutta A, Macchi E, Coppola A, Saccomanno A, Gatta T, Recaldini C, Minenna M, Tamborini C, Dossi F, Ascenti V, Barbera S, Cicero G, Carcano G, Ascenti G, Castiglioni B, Venturini M. Transcatheter Aortic Valve Implantation (TAVI) Planning with Dual-Layer Spectral CT Using Virtual Monoenergetic Image (VMI) Reconstructions and 20 mL of Contrast Media. J Clin Med 2024;13:524. [PMID: 38256659 PMCID: PMC10816911 DOI: 10.3390/jcm13020524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open

Affiliation(s)

Federico Fontana Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.) Postgraduate School of Radiology Technician, Insubria University, 21100 Varese, Italy;
Filippo Piacentino Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
Aroa Gnesutta Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
Edoardo Macchi Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
Andrea Coppola Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
Angiola Saccomanno Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
Tonia Gatta Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
Chiara Recaldini Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.)
Manuela Minenna Postgraduate School of Radiology Technician, Insubria University, 21100 Varese, Italy;
Claudio Tamborini Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
Filippo Dossi Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
Velio Ascenti Postgraduate School of Radiodiagnostics, Policlinico Universitario, University of Milan, 20133 Milano, Italy;
Simone Barbera Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
Giuseppe Cicero Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
Giulio Carcano Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy;
Giorgio Ascenti Diagnostic and Interventional Radiology Unit, Biomorf Department, University Hospital Messina, 98124 Messina, Italy; (S.B.); (G.C.); (G.A.)
Battistina Castiglioni Department of Cardiovascular Diseases, ASST Settelaghi, 21100 Varese, Italy; (C.T.); (F.D.); (B.C.)
Massimo Venturini Diagnostic and Interventional Radiology Unit, Circolo Hospital, ASST Sette Laghi, 21100 Varese, Italy; (F.F.); (A.G.); (E.M.); (A.S.); (T.G.); (C.R.); (M.V.) Department of Medicine and Technological Innovation, Insubria University, 21100 Varese, Italy;

Collapse