Photo: Darnyi Zsóka / Wikimedia Commons (archive)
Earlier catheter-based aortic valve replacement reduced a combined measure of death or heart-failure events in selected older patients with moderate valve narrowing, according to PROGRESS trial results presented Monday. The benefit was driven by fewer heart-failure events, not a demonstrated reduction in deaths.
At two years, 16.7% of patients assigned to early treatment had died or experienced a heart-failure event, compared with 23.9% under clinical surveillance, the American College of Cardiology reported. The absolute difference was 7.2 percentage points.
Who was studied
The randomized study enrolled 744 patients at 74 centers across six countries. Their average age was about 78, and each had moderate aortic stenosis plus at least one risk feature, such as symptoms or evidence of heart damage or dysfunction.
Aortic stenosis is a narrowing of the valve through which blood leaves the heart. The catheter procedure, known as TAVR or TAVI, replaces the valve without conventional open-heart surgery. The study tested earlier treatment against monitoring with valve replacement later when indicated.
Hospitalizations fell; mortality did not
Heart-failure hospitalization occurred in 7.4% of the early-treatment group and 14.9% of the surveillance group. All-cause mortality was similar between groups, according to TCTMD’s report. Patients assigned to earlier treatment also reported better quality of life.
The results were presented at the TCT 2026 conference in San Diego and published simultaneously in The New England Journal of Medicine. Valve maker Edwards Lifesciences announced the findings for the trial of its SAPIEN 3 platform.
Not a recommendation for everyone with moderate disease
Edwards says using its SAPIEN 3 TAVR systems for moderate aortic stenosis remains investigational. The trial result is not a new FDA approval for that use.
An accompanying editorial by Catherine Otto cautioned that TAVR is not appropriate for most adults with moderate aortic stenosis. It may be considered for selected older high-risk patients when other approaches are ineffective, according to the ACC summary. Longer follow-up, valve-durability data and cost analyses remain important, TCTMD reported.
The findings support specialist evaluation of appropriate patients rather than a blanket call for immediate intervention. The featured stethoscope photograph is an illustrative archive, not a trial device, trial site or procedure image.
JBizNews Desk | San Diego
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