• 2025 European Society of Cardiology (ESC ) guidelines include a new Class IIa recommendation for considering intervention in asymptomatic patients with severe aortic stenosis, if the procedural risk is low.
• This recommendation is based on four trials comparing early intervention to conservative management in this patient group.
• Positive outcomes in these trials were driven mainly by a reduction in unplanned hospitalisations rather than mortality. A meta-analysis also demonstrated a reduction in stroke in the early intervention group.
• The studies were heterogenous and included several design limitations that have been explored in critical reviews. There is also a lack of data regarding patient selection for early intervention.
Author Sub-editor: Dr Pok-Tin Tang Dr Pok-Tin Tang is an ST5 cardiology registrar in the Thames Valley deanery, currently undertaking a period of out of
Author Sub-editor: Dr May Hu Dr May Hu is a cardiology trainee in the North West deanery. She graduated with First Class Honours from the University
Author Sub-editor: Dr Jhiamluka Solano Dr Jhiamluka Solano is a cardiology resident doctor (ST6) in the Yorkshire and Humber Deanery, currently undertaking a DPhil (PhD)
Author Sub-editor: Dr Joshua Rowland Dr Joshua Rowland is a cardiology registrar working in the North West Deanery. He graduated from the University of Manchester
Author Sub-editor: Dr Atmadeep Banerjee Dr Atmadeep Banerjee is an ST4 Cardiology Registrar in the Kent, Surrey and Sussex deanery. He graduated from Calcutta National
