AVATAR
Aortic Valve replAcemenT versus conservative treatment in Asymptomatic seveRe aortic stenosis
Patient / Population Intervention / Exposure Comparison Outcome
In 157 patients with asymptomatic severe aortic stenosis, early aortic valve replacement reduced death, MI, stroke, or HF hospitalisation compared with watchful waiting.
N
157
Design
Multicentre open-label RCT
Endpoint
All-cause death, MI, stroke, or unplanned HF hospitalisation
Relevance
3
ResultEarly surgery 15.2% vs conservative 34.7% (HR 0.46, 95% CI 0.23-0.90, P=0.02) over median 32 months; individual components not separately significant.
Banovic M, et al. Circulation. 2022;145(9):648-58. 10.1161/CIRCULATIONAHA.121.057639
Discussion & critique
Small (n=157), open-label, driven by a composite rather than hard mortality. With RECOVERY supports earlier intervention in asymptomatic severe AS and informs the guideline shift toward earlier AVR.