A recent study published in the New England Journal of Medicine has groundbreaking results and is set to transform how heart patients are treated. Led by Philippe Genereux, MD, medical director of the Structural Heart Program at Atlantic Health System’s Morristown Medical Center, the study could help heart patients receive care earlier and avoid risks like stroke, congestive heart failure, and unnecessary hospital stays.
Dr. Genereux, an interventional cardiologist and principal investigator of the EARLY TAVR trial, is one of the world’s most highly cited researchers. “Aortic stenosis is not a disease that is stopped in time,” he says. “We need to see it for what it is: a progressive disease.”
About aortic stenosis and the TAVR procedure
Aortic stenosis, or AS, is the most common form of heart valve disease. Transcatheter aortic valve replacement, or TAVR, is a minimally invasive way to replace a diseased aortic valve for patients who are too high risk for open-heart surgery. Since cardiovascular stenosis becomes worse over time — and is one of the main causes of heart failure — TAVR often is the solution that saves a patient’s life.
Treatment recommendations for severe aortic stenosis are made by the American College of Cardiology and the American Heart Association. Typically, there’s no intervention until symptoms of heart failure appear. The guidelines, set decades ago, call for routine follow up every six to 12 months.
EARLY TAVR study results show benefits to early intervention
The EARLY TAVR study followed more than 900 patients for up to eight years. It measured rates of death, stroke and unplanned hospital stays caused by heart-related issues. Specifically, the study looked at the benefit of early valve replacement for patients with severe AS who don’t yet have symptoms of heart failure.
The results of the leading-edge study confirm for Dr. Genereux and his team of researchers that performing the TAVR heart procedure early may be the best solution since it can improve patient outcomes as much as 50% compared to watchful waiting.
In addition, watchful waiting often fails patients because, as the study revealed, 26% of patients began having symptoms within six months, and 47% faced symptoms within 12 months.
“The study shows there’s no penalty to pay with early intervention compared to clinical surveillance. With early TAVR, you’re going to prevent the decline in quality of life and prevent some cardiac damage,” Dr. Genereux says. “AS is a deadly disease. So if doctors refer a patient early, and we treat it even when you have no symptoms, you’ll have fewer hospitalizations and fewer complications.”
Since symptoms of heart failure are sure to develop for those with severe AS — perhaps soon and more severe — often, there’s no time to wait. Thanks to data from this groundbreaking study, Dr. Genereux explains that now, “We can begin an era of proactivity instead of reactivity.”
“The good news with this trial is that it’s going to simplify how we manage patients with severe aortic stenosis who don’t yet have symptoms,” he says. “Severe AS with no symptoms is a very important problem to conquer by cardiologists.”
As a result, many heart patients’ quality of life may be improved, and lives can be saved.
Be proactive about your health
Staying up to date on annual wellness exams and screenings is important. So too, are the occasional trips to specialists to address sleep issues or any other health concerns that are nagging you.
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