来自PARTNER 2A试验5年数据发现,对于有中度手术风险的重度AS患者,接受经导管主动脉瓣置换术(TAVR)和外科主动脉瓣置换术(SAVR)的死亡率和致残性卒中发生率相似。
来自PARTNER 2A试验5年数据发现,对于有中度手术风险的重度AS患者,接受经导管主动脉瓣置换术(TAVR)和外科主动脉瓣置换术(SAVR)的死亡率和致残性卒中发生率相似。但与SAVR相比,采用经胸腔入路的TAVR的预后较差。
Press Release
TCT 2019|PARTNER 2A
研究结果于第三十一届经导管心血管治疗(TCT)学术会议上公布。TCT是心血管研究基金会(CRF)赞助的世界上最重要的心血管介入医学教育会议。
PARTNER 2A试验的两年结果得出结论,对于有中度手术风险的重度AS患者,TAVR和外科手术在死亡率或致残性卒中发生率的主要终点相似。在这一人群中,关于长期临床结局和生物瓣膜功能的数据有限,本试验的目的是在于对比TAVR和SAVR对于中度风险的重度AS中5年的主要临床结局、生物瓣膜功能和生活质量的差别。
研究人员在57个中心随机纳入2032名重度AS患者进行TAVR或SAVR治疗。在意向治疗(ITT)人群中,主要观察终点为2年全因死亡率和致残性卒中发生率。在5年时,对ITT和预先指定的治疗(AT)人群的所有主要和次要临床和回声终点进行分析。
5年时,TAVR组死亡或致残卒中主要终点的事件发生率为47.9%,SAVR组为43.4%(HR=1.09;95%CI:0.95~1.25;P=0.21)。在股动脉入路队列中,5年时也没有差异(44.5%TAVR vs. 42.0%SAVR;HR=1.02;95%CI:0.87~1.20;P=0.80)。然而,在经胸入路队列中,TAVR术后死亡或致残性卒中的发生率显著高于对照组(59.3% vs. 48.3%;HR=1.32;95%CI:1.02~1.71; P=0.03)。此外,TAVR和SAVR患者的功能状态和生活质量在5年内都得到早期改善。
Medstar心脏与血管研究所心脏外科主任Vinod H.Thourani医学博士说:“在中度风险的重度AS患者的长期随访中发现,TAVR和SAVR的死亡率和致残性卒中发生率相似。”对于重度主动脉瓣狭窄的中危患者,TAVR应被视为外科手术的替代方法。但对于没有可接受的经股动脉入路的患者,外科手术可能是首选替代方法。”
Slides
TCT 2019|PARTNER 2A
About CRF and TCT
The Cardiovascular Research Foundation (CRF) is one of the world’s leading nonprofit organizations specializing in interventional cardiology innovation, research, and education. CRF is dedicated to helping doctors improve survival and quality of life for people suffering from heart and vascular disease. For nearly 30 years, CRF has helped pioneer medical advances and educated doctors on the latest treatments for heart disease. CRF is comprised of the CRF Skirball Center for Innovation, CRF Clinical Trials Center, CRF Center for Education, CRF Digital, TCTMD, and Structural Heart: The Journal of the Heart Team.
Transcatheter Cardiovascular Therapeutics (TCT) is the annual scientific symposium of CRF and the premier educational meeting specializing in interventional cardiovascular medicine. Now in its 31st year, TCT features major medical research breakthroughs and gathers leading researchers and clinicians from around the world to present and discuss the latest evidence-based research in the field. TCT also includes interactive training pavilions where clinicians can gain vital skills to apply immediately to their practices.
For more information,
visit www.crf.org and www.tctconference.com.