Ischemic vs. Nonischemic Cardiomyopathy in TAVR for Moderate Aortic Stenosis: A TAVR UNLOAD Sub Analysis

TL;DR

This study found no clear difference in treatment outcomes for TAVR in heart failure patients with ischemic or nonischemic cardiomyopathy and moderate aortic stenosis.

Contribution

The study explores whether cardiomyopathy etiology affects TAVR outcomes in patients with moderate aortic stenosis and heart failure.

Findings

No differential treatment effect of TAVR was found based on cardiomyopathy etiology.

The study lacked sufficient power to rule out potential effects of cardiomyopathy type.

Longer follow-up may be needed to detect any treatment differences.

Abstract

•This exploratory analysis of the Transcatheter Aortic Valve Replacement to UNload the Left ventricle in patients with ADvanced heart failure trial did not identify evidence of a differential treatment effect of transcatheter aortic valve replacement compared to clinical aortic stenosis surveillance according to cardiomyopathy etiology (ischemic versus nonischemic) in patients with heart failure with reduced ejection fraction and moderate aortic stenosis.•The study was underpowered to definitively exclude a potential modifying effect of cardiomyopathy etiology, and any differential treatment response may require longer follow-up to become apparent.

This exploratory analysis of the Transcatheter Aortic Valve Replacement to UNload the Left ventricle in patients with ADvanced heart failure trial did not identify evidence of a differential treatment effect of transcatheter aortic valve replacement compared to clinical aortic stenosis surveillance according to cardiomyopathy etiology (ischemic versus nonischemic) in patients with heart failure with reduced ejection fraction and moderate aortic stenosis.

The study was underpowered to definitively exclude a potential modifying effect of cardiomyopathy etiology, and any differential treatment response may require longer follow-up to become apparent.

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