{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:03:58Z","timestamp":1790240638093,"version":"4.1.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The incidence of outcomes in trials comparing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) is expected to be different in the short and long term. We planned a meta-analysis of reconstructed time-to-event data from trials comparing TAVI and SAVR to evaluate their time-varying effects on outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We performed a systematic review of the literature from January 2007 through September 2021 on Medline, Embase, the Cochrane Central Register of Controlled Trials and specialistic websites, including randomized trials with allocation to TAVI or SAVR that reported at least 1-year follow-up and that graphed Kaplan\u2013Meier curves of end points. The comparisons were done with grouped frailty Cox models in a landmark framework and fully parametric models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Seven trials were included (7770 participants). TAVI showed a lower incidence of the composite of death or stroke in the first 6\u2009months [risk-stratified hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.56\u20130.77, P-value &amp;lt;0.001], with an HR reversal after 24\u2009months favouring SAVR (risk-stratified HR 1.25; 95% CI 1.08\u20131.46; P-value 0.003). These outcomes were confirmed for all-cause death (risk-stratified HR after 24\u2009months 1.18; 95% CI 1.03\u20131.35; P-value 0.01). TAVI was also associated with an increased incidence of rehospitalization after 6\u2009months (risk-stratified HR 1.42; 95% CI 1.06\u20131.91; P-value 0.018) that got worse after 24\u2009months (risk-stratified HR 1.67; 95% CI 1.24\u20132.24; P-value &amp;lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Although it could appear that there is no difference between TAVI and SAVR in the 5-year cumulative results, TAVI shows a strong protective effect in the short term that runs out after 1\u2009year. TAVI becomes a risk factor for all-cause mortality and the composite end point after 24\u2009months and for rehospitalization after 6\u2009months.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab516","type":"journal-article","created":{"date-parts":[[2021,11,23]],"date-time":"2021-11-23T20:26:37Z","timestamp":1637699197000},"page":"977-987","source":"Crossref","is-referenced-by-count":40,"title":["Five-year outcomes in trials comparing transcatheter aortic valve implantation versus surgical aortic valve replacement: a pooled meta-analysis of reconstructed time-to-event data"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9737-6087","authenticated-orcid":false,"given":"Fabio","family":"Barili","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, S. Croce Hospital, Cuneo, Italy"},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Freemantle","sequence":"additional","affiliation":[{"name":"Institute of Clinical Trials and Methodology, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Musumeci","sequence":"additional","affiliation":[{"name":"Department of Heart and Vessels, Cardiac Surgery Unit and Heart Transplantation Center, S. Camillo-Forlanini Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Research and Third Mission Area, University of Turin, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1304-6644","authenticated-orcid":false,"given":"Amedeo","family":"Anselmi","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, AOU \u201cCitt\u00e0 della Salute e della Scienza di Torino\u201d, University of Turin, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9715-9960","authenticated-orcid":false,"given":"Jorge","family":"Rodriguez-Roda","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ramon y Cajal University Hospital, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2611-5626","authenticated-orcid":false,"given":"Michele","family":"Di Mauro","sequence":"additional","affiliation":[{"name":"Cardiothoracic and Vascular Department, Maastricht University Medical Center, Maastricht, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Folliguet","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, H\u00f4pital Henri Mondor, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Verhoye","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Sousa-Uva","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Hospital de Santa Crux, Carnaxide, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6954-0422","authenticated-orcid":false,"given":"Alessandro","family":"Parolari","sequence":"additional","affiliation":[{"name":"Universitary Cardiac Surgery Unit, IRCCS Policlinico S. Donato, Italy"},{"name":"Department of Biomedical Sciences for Health, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Latin European Alliance of CardioVascular Surgical Societies (LEACSS) and with the endorsement of the Latin American Association of Cardiac and Endovascular Surgery (LACES), LEACSS members are the Italian Society of Cardiac Surgery (FB FM MR MdM AP), the Portuguese Society of Cardiac Surgery (MSU), the French Society of Cardiac Surgery (JFV, AA) and the Spanish Society of Cardiac Surgery (JRR) Institutions","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"2022050515421276700_ezab516-B1","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS guidelines for the management of valvular heart 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