PARTNER cohort A trial - Summary & Results

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A randomized clinical trial on placement of aortic transcatheter valve (PARTNER cohort A) comparing transcatheter aortic-valve implantation (TAVI) with surgery for severe aortic stenosis in elderly patients

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PARTNER cohort A trial - Summary & Results

  1. 1. PARTNER cohort A (Placement of AorticTranscatheter Valve Trial)
  2. 2. PARTNER cohort A (Placement of Aortic TranscatheterValve Trial)C Smith (Columbia University, New York)American College of Cardiology 2011 Scientific Sessions• A randomized clinical trial comparing transcatheter aortic-valve implantation (TAVI) with surgery for severe aortic stenosis• Population and treatment: 699 elderly patients with severe aortic stenosis randomized to TAVI or conventional surgery TAVI patients were implanted via the fully transfemoral route or via a transapical procedure—typically used when the femoral artery was deemed unsuited to TAVI catheters• Outcomes (at 30 days and one year): Primary end point: All-cause mortality Secondary end points: Included major stroke and the combined end point of all stroke or transient ischemic attack (TIA)
  3. 3. PARTNER Cohort A: Results• Mortality: Numerically but not statistically lower in the TAVI group at 30 days; noninferiority criteria met at one year• Major strokes: Higher in TAVI-treated patients at 30 days and one year• All stroke or TIA: Statistically greater with TAVI at 30 days and one yearOutcomes Outcome TAVI (%) Surgery (%) p Mortality, 30 d 3.4 6.5 NS Mortality, 1 y 24.2 26.8 NS Major stroke, 30 d 3.8 2.1 0.20 Major stroke, 1 y 5.1 2.4 0.07 All stroke or TIA, 30 d 5.5 2.4 0.04 All stroke or TIA, 1 y 8.3 4.3 0.04
  4. 4. PARTNER Cohort A: Commentary*"An absolutely spectacular trial. . . . This is one of the biggest steps incardiovascular medicine in our lifetime." - Dr David Moliterno"A win for everybody. Surgery looked good; transcatheter-valve replacement lookedgood." - Dr Michael Mack"Its hard to make a noninferiority study sound exciting, but the point is that, overall,TAVI was better than equivalent, it was noninferior." - Dr John Webb*All comments from PARTNER cohort A: Transcatheter valves noninferior to surgery(http://www.theheart.org/article/1204701.do)
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