Evidence map›Paper›PMID 38191233›Full record

SynthesisOpen heart2024

Systematic review and meta-analysis of early aortic valve replacement versus conservative therapy in patients with asymptomatic aortic valve stenosis with preserved left ventricle systolic function.

Nagendra Boopathy Senguttuvan, Nishok Victory Srinivasan, Manokar Panchanatham, Rizwan Suliankatchi Abdulkader, Asuwin Anandaram, Dinesh Reddy Polareddy, Sankaran Ramesh, Harsimran Singh, Hanumath Yallanki, Dhamodaran Kaliyamoorthi and 8 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Aortic Valve Replacement in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta-Analysis.Journal of the Society for Cardiovascular Angiography & Interventions · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 9 institutions in 3 countries.

Nagendra Boopathy SenguttuvanDepartment of Cardiology, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India drsnboopathy@gmail.com.ORCID 0000-0003-4979-596X
Nishok Victory SrinivasanDepartment of Clinical Research, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.
Manokar PanchanathamDepartment of Cardiology, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.
Rizwan Suliankatchi AbdulkaderDepartment of Statistics, National Institute of Epidemiology, Chennai, Tamil Nadu, India.
Asuwin AnandaramDepartment of Clinical Research, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.
Dinesh Reddy PolareddyDepartment of Cardiology, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.ORCID 0009-0009-4155-1435
Sankaran RameshDepartment of Cardiology, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.
Harsimran SinghDepartment of Cardiology, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.
Hanumath YallankiDepartment of Medicine, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.
Dhamodaran KaliyamoorthiCardiology, Apollo Hospitals, Chennai, Tamil Nadu, India.
Sundar ChidambaramDepartment of Cardiology, Kauvery Hospital, Chennai, India.
Vadivelu RamalingamDepartment of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India.
Ravindran RajendranDepartment of Cardiology, Apollo Hospitals, Trichy, Tamil Nadu, India.
Thoddi Ramamurthy MuralidharanDepartment of Cardiology, SRIHER (Deemed to be University), Chennai, Tamil Nadu, India.
Ravindar RaoDepartment of Cardiology, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
Ashok SethDepartment of Cardiology, Fortis Escorts Heart Institute and Research Centre, New Delhi, Delhi, India.
Bimmer ClaessenDepartment of Cardiology, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
Parasuram KrishnamoorthyCardiology, Icahn School of Medicine at Mount Sinai Zena and Michael A Wiener Cardiovascular Institute, New York, New York, USA.
Amsterdam University Medical Centers · NLApollo Hospitals · INApollo Hospitals · INFortis Escorts Heart Institute · INIcahn School of Medicine at Mount Sinai · USNational Institute of Epidemiology · INRajasthan University of Health Sciences · INSooriya Hospital · INVelammal Medical College Hospital and Research Institute · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA quarter of patients with severe aortic stenosis (AS) were asymptomatic, and only a third of them survived at the end of 4 years. Only a select subset of these patients was recommended for aortic valve replacement (AVR) by the current American College of Cardiology/American Heart Association guidelines. We intended to study the effect of early AVR (eAVR) in this subset of asymptomatic patients with preserved left ventricle function. METHODS AND

resultsWe searched PubMed and Embase for randomised and observational studies comparing the effect of eAVR versus conservative therapy in patients with severe, asymptomatic AS and normal left ventricular function. The primary outcome was all-cause mortality. The secondary outcomes were composite major adverse cardiac events (MACE) (study defined), myocardial infarction (MI), stroke, cardiac death, sudden death, the development of symptoms, heart failure hospitalisations and major bleeding. We used GRADEPro to assess the certainty of the evidence. In the randomised controlled trial (RCT) only analysis, we found no significant difference in all-cause mortality between the early aortic intervention group versus the conservative arm (CA) (incidence rate ratio, IRR (CI): 0.5 (0.2 to 1.1), I

conclusionWe conclude that there is no reduction in all-cause mortality in the eAVR arm in patients with asymptomatic AS with preserved ejection fraction. However, eAVR reduces heart failure related hospitalisations and death or heart failure hospitalisations. PROSPERO REGISTRATION NUMBER: CRD42022306132.

Indexed as

Aortic Valve StenosisHeart Valve Prosthesis ImplantationAortic ValveConservative TreatmentDeath, Sudden, CardiacHeart FailureHemorrhageHumansMyocardial InfarctionStrokeTranscatheter Aortic Valve ReplacementUnited StatesVentricular Function, LeftAortic Valve StenosisHeart Valve Prosthesis ImplantationOutcome Assessment, Health CareTranscatheter Aortic Valve Replacement

Identifiers

PMID38191233
PMCPMC10806528
OpenAlexW4390699341

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.