Conclusion: Overall, the current approach of managing patients based on the dominant lesion might be too reductionist and a more holistic approach including biomarkers and multimodality imaging cardiac remodelling and inflammation data might be more appropriate.

Background: End-stage valvular aortic stenosis obstructs blood flow from the left ventricle into the aorta. Prior to development of the heart-lung machine in 1953, other than a few reports of direct fracture of the stenosed valve on a beating heart or with hypothermic cardiac arrest, there were no effective treatments for relief of outflow...

Meaning: Among patients aged 70 years or older with severe, symptomatic aortic stenosis and moderately increased operative risk, treatment with TAVI was noninferior to surgery with respect to all-cause mortality at 1 year.

Conclusions: The results of this large population-based real-world study support the use of statins and RAS inhibitors for patients who underwent SAVR due to aortic stenosis.

Conclusions and Relevance: Epidemiologic and genetic studies suggest a potentially causal association between elevated Lp(a) levels, atherosclerotic cardiovascular disease, and aortic valve stenosis. Emerging nucleic acid–based therapies have potent Lp(a)-lowering effects and appear safe; phase 3 trials will establish whether they improve...