# Early Aortic Valve Replacement Versus Conservative Management: A Meta-Analysis of Randomized Controlled Trials

## TL;DR

Replacing aortic valves early before severe symptoms may not improve most outcomes but could reduce stroke risk.

## Contribution

A meta-analysis comparing early aortic valve replacement with conservative management reveals stroke benefits but unclear mechanisms.

## Key findings

- Early aortic valve replacement does not improve mortality or myocardial infarction outcomes.
- Early replacement is associated with a reduced risk of stroke.
- Younger patients and women may benefit more from early replacement, though this needs further study.

## Abstract

•Early aortic valve replacement before the development of severe symptomatic aortic stenosis is not associated with a benefit for most hard endpoints including mortality and myocardial infarction but is associated with a benefit in stroke.•The mechanism for the potential benefit of early aortic valve replacement on stroke remains unclear.•Younger patients and women may derive a mortality benefit from early aortic valve replacement, but this warrants further study.

Early aortic valve replacement before the development of severe symptomatic aortic stenosis is not associated with a benefit for most hard endpoints including mortality and myocardial infarction but is associated with a benefit in stroke.

The mechanism for the potential benefit of early aortic valve replacement on stroke remains unclear.

Younger patients and women may derive a mortality benefit from early aortic valve replacement, but this warrants further study.