TCT 2020 | Acurate Neo Does Not Meet Non-Inferiority vs. CoreValve Evolut

The self-expanding Acurate Neo (Boston Scientific) did not meet non-inferiority vs. the self-expanding CoreValve Evolut (Medtronic) in the SCOPE 2 study published in Circulation simultaneously and presented at the virtual TCT 2020.

TCT 2020 | La Acurate Neo no alcanza la no inferioridad vs la CoreValve Evolut

These are bad news for the Acurate Neo, that had already failed to show non-inferiority vs. the Sapien 3 in the SCOPE 1 (30-day followup) presented at last year’s TCT’s annual meeting. 

This head to head study of two self-expanding supra-annular valves showed the already tested CoreValve Evolut is a better choice to treat aortic stenosis. 

The primary end point of death or stroke at one year was 15.8% for patients receiving the Acurate Neo vs 13.9% for the CoreValve Evolut. With this difference, the Acurate Neo failed to reach non-inferiority. All-cause mortality resulted similar, but cardiac death resulted higher for the Boston valve. 

Paravalvular failure moderate or severe at 30 days also resulted significantly higher with the Acurate Neo (10% vs 3%; p=0.002).


Read also: TCT 2020 | Crushed Prasugrel Administration prior PCI.


The SCOPE 2 was carried out in 23 high volume European centers and included 796 high surgical risk patients over 75. 

The Acurate Neo would have the advantage of providing better future access to the coronaries and better definite pacemaker or left bundle branch block rates, but this must counterbalance a higher rate of aortic regurgitation vs. the two gold standard valves. 

Boston is redesigning the device that presents an annular sealing that would adapt better to irregular calcified anatomies, reducing aortic regurgitation. Reducing paravalvular regurgitation could impact the observed mortality at 30 days and one year. 

tct-SCOPE-2

Original Title: Comparison of self-expanding bioprostheses for transcatheter aortic valve replacement in patients with symptomatic severe aortic stenosis: the SCOPE 2 randomized clinical trial.

Reference: Capodanno D et al. Circulation. 2020; Epub ahead of print y presentado simultáneamente en el congreso TCT 2020 virtual.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

 

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....