Baseline characteristics of the study patients according to the treatment
| Entire cohort | Non-SAVR | SAVR | ||
| Variables | N=570 | N=360 | N=210 | P value* |
| Clinical demographics | ||||
| Age, years | 78.6 (9.0) | 80.9 (8.3) | 74.6 (8.8) | <0.001 |
| Age >80 years | 297 (52) | 224 (62) | 63 (30) | <0.001 |
| Male sex | 236 (41) | 142 (39) | 94 (45) | 0.22 |
| BMI, kg/m2 | 22.1 (3.4) | 21.6 (3.4) | 22.8 (3.2) | <0.001 |
| Underweight (BMI <18.5 kg/m2) | 83 (15) | 72 (20) | 11 (5) | <0.001 |
| BSA, m2 | 1.47 (0.17) | 1.44 (0.16) | 1.51 (0.18) | <0.001 |
| Symptom at enrolment | ||||
| NYHA class I | 256 (45) | 167 (46) | 61 (29) | <0.001 |
| NYHA class II | 217 (38) | 121 (34) | 123 (59) | |
| NYHA class III | 85 (15) | 63 (18) | 23 (11) | |
| NYHA class IV | 12 (2) | 9 (3) | 3 (1) | |
| Hypertension | 175 (31) | 251 (70) | 144 (69) | 0.78 |
| Diabetes | 155 (27) | 95 (26) | 60 (29) | 0.63 |
| Dyslipidaemia | 229 (40) | 133 (37) | 96 (46) | 0.04 |
| Hyperuricaemia | 63 (11) | 40 (11) | 23 (11) | 1.00 |
| Prior heart failure | 205 (36) | 117 (33) | 88 (42) | 0.03 |
| Coronary artery disease | 230 (40) | 155 (43) | 75 (36) | 0.09 |
| Old myocardial infarction | 78 (14) | 60 (17) | 18 (9) | 0.01 |
| Previous heart surgery | 100 (18) | 73 (20) | 27 (13) | 0.03 |
| eGFR (mL/min/1.73 cm2) | 32 (20) | 27 (19) | 40 (20) | <0.001 |
| Renal insufficiency | 270 (47) | 211 (59) | 59 (28) | <0.001 |
| Haemodialysis | 69 (12) | 49 (14) | 20 (10) | 0.18 |
| Chronic lung disease | 61 (11) | 39 (11) | 22 (11) | 1.00 |
| Previous stroke | 77 (14) | 54 (15) | 24 (11) | 0.26 |
| Atrial fibrillation | 105 (18) | 68 (19) | 37 (18) | 0.74 |
| Peripheral vascular disease | 83 (15) | 66 (18) | 17 (8) | 0.001 |
| Aortic aneurysm or dissection | 40 (7) | 27 (8) | 13 (6) | 0.61 |
| Malignancy | 78 (14) | 61 (17) | 17 (8) | 0.003 |
| Chronic liver disease | 25 (4) | 16 (4) | 9 (4) | 1.00 |
| Peptic ulcer disease | 43 (8) | 30 (8) | 13 (6) | 0.41 |
| Limited activity | 110 (19) | 103 (29) | 7 (3) | <0.001 |
| Current smoker | 36 (6) | 22 (6) | 14 (7) | 0.86 |
| EuroSCORE II (%)† | 3.3 (2.0–5.4) | 3.8 (2.6–6.2) | 2.3 (1.5–3.9) | <0.001 |
| STS score (PROM) (%)† | 4.2 (2.8–6.6) | 4.9 (3.4–7.5) | 3.1 (1.9–4.1) | <0.001 |
| Medication use | ||||
| Antiplatelet | 290 (51) | 192 (53) | 98 (47) | 0.14 |
| β-blocker | 144 (25) | 88 (24) | 56 (27) | 0.55 |
| ACE inhibitor or ARB | 324 (57) | 145 (40) | 101 (48) | 0.08 |
| Statins | 202 (35) | 118 (33) | 84 (40) | 0.09 |
| Calcium channel blockers | 246 (43) | 165 (46) | 81 (39) | 0.10 |
| Anticoagulant | 132 (23) | 82 (23) | 50 (24) | 0.84 |
| Corticosteroids | 14 (3) | 11 (3) | 3 (1) | 0.27 |
| Echocardiographic assessment | ||||
| Left ventricular ejection fraction (%) | 61 (12) | 60 (13) | 62 (11) | 0.04 |
| Aortic valve area (cm2) | 0.73 (0.18) | 0.76 (0.18) | 0.67 (0.15) | <0.001 |
| Peak aortic velocity (m/s) | 3.7 (0.9) | 3.4 (0.9) | 4.3 (0.8) | <0.001 |
| Peak aortic velocity >4.0 m/s | 233 (41) | 90 (25) | 143 (68) | <0.001 |
| Mean aortic gradient (mm Hg) | 34 (19) | 29 (18) | 45 (19) | <0.001 |
| Aortic regurgitation (grade III–IV) | 35 (6) | 17 (5) | 18 (9) | 0.14 |
| Mitral regurgitation (grade III–IV) | 44 (8) | 23 (6) | 21 (10) | 0.87 |
| Tricuspid regurgitation (grade III–IV) | 44 (8) | 28 (9) | 16 (9) | 1.00 |
| Surgical procedure | ||||
| Valve profile | ||||
| Bioprosthetic valve, n (%) | 161 (77) | |||
| Mechanical valve, n (%) | 44 (21) | |||
| Unknown | 5 (2) | |||
| Associated procedures, n (%) | 102 (49) | |||
| Coronary artery bypass grafting | 43 (20) | |||
| Mitral valve replacement or repair | 50 (24) | |||
| Tricuspid valve replacement or repair | 17 (8) | |||
| Ascending aorta replacement | 13 (6) | |||
*P value refers to comparisons between the non-SAVR group at enrolment and the SAVR group at operation.
†Median and IQR. Data are mean (SD) or n (%).
ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; BMI, body mass index; BSA, body surface area; NYHA class, New York Heart Association functional classification; PROM, predicted risk of mortality; SAVR, surgical aortic valve replacement; STS, Society of Thoracic Surgery; eGFR, estimated glomerular filtration rate.