{"id":27620,"date":"2012-03-26T09:14:15","date_gmt":"2012-03-26T13:14:15","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=27620"},"modified":"2012-03-26T09:14:15","modified_gmt":"2012-03-26T13:14:15","slug":"partner-tavr-results-appear-durable-at-2-years","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/03\/26\/partner-tavr-results-appear-durable-at-2-years\/","title":{"rendered":"PARTNER: TAVR Results Appear Durable at 2 Years"},"content":{"rendered":"<p>Two-year results of the influential PARTNER trial provide continued support for the growing acceptance of\u00a0transcatheter aortic valve replacement (TAVR) in clinical practice. Previously,\u00a0<a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1103510\">results of PARTNER at 1 year<\/a>\u00a0had demonstrated similar mortality in high-risk patients with aortic stenosis who underwent TAVR or surgery. Now, the 2-year results have been presented at the American College of Cardiology and <a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1200384\">published simultaneously in the\u00a0<em>New England Journal of Medicine<\/em><\/a>.<\/p>\n<p>Two-year mortality:<\/p>\n<ul>\n<li>ITT analysis: 33.9% in the TAVR group and 35.0% in the AVR group (HR 0.90, CI 0.71-1.15, p=0.41)<\/li>\n<li>As-treated analysis:\u00a033.9% and 32.7% (HR 0.98, CI 0.76-1.25, p=0.85)<\/li>\n<\/ul>\n<p>Stroke at 2 years:<\/p>\n<ul>\n<li>ITT: 7.7% and 4.9% (HR 1.22, CI 0.67-2.23, p=0.52)<\/li>\n<\/ul>\n<p>All-cause mortality or stroke at 2 years:<\/p>\n<ul>\n<li>ITT: 37.1% and 36.4% (HR 0.93, CI 0.73-1.18, p=0.55)<\/li>\n<\/ul>\n<p>The PARTNER investigators reported that the valve gradients and areas were similar between TAVR and AVR at 2 years and that they had found no evidence of structural valve deterioration. However, periprocedural aortic regurgitation was a highly significant predictor of late mortality (p&lt;0.001).<\/p>\n<p>&#8220;We\u2019re most concerned about valve durability, which you have to look at over five to 10 years, but any longer-term information is useful because trends tend to hold true over time,&#8221; said Susheel Kodali, who presented the results, in an ACC press release. &#8220;We have no evidence that the initial good results in improved valve performance have deteriorated during the follow-up to this time point. TAVR appears to be as durable as AVR.<\/p>\n<p>&#8220;During this follow-up, we observed that significant leakiness around the valve was associated with higher subsequent mortality in TAVR patients, but it&#8217;s important to note that overall mortality between the two groups is the same,&#8221; he said. &#8220;Now we have a target \u2013 we know what to fix in the future. TAVR is already comparable to results for AVR in the most experienced surgeons&#8217; hands. If we can reduce these leaks, there&#8217;s a good chance we can reduce mortality with TAVR even more.&#8221;<\/p>\n<div>The PARTNER investigators concluded that the study &#8220;supports the use of TAVR as an alternative to surgery in selected high-risk patients with aortic stenosis.&#8221;<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Two-year results of the influential PARTNER trial provide continued support for the growing acceptance of\u00a0transcatheter aortic valve replacement (TAVR) in clinical practice. Previously,\u00a0results of PARTNER at 1 year\u00a0had demonstrated similar mortality in high-risk patients with aortic stenosis who underwent TAVR or surgery. Now, the 2-year results have been presented at the American College of Cardiology [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20,9],"tags":[794,424,396,770],"class_list":["post-27620","post","type-post","status-publish","format-standard","hentry","category-cardiac-surgery","category-interventional-cardiology","tag-aortic-stenosis","tag-aortic-valve-replacement","tag-partner","tag-tavr"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27620","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=27620"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/27620\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=27620"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=27620"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=27620"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}