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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2026, Number 2

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Cir Card Mex 2026; 11 (2)

PARTNER 3 at 7 years: temporal heterogeneity, endpoint architecture, and the limits of long-term equivalence

García-Villarreal OA

Language: English
References: 13
Page: 54-58
PDF size: 551.11 Kb.


ABSTRACT

The 7-year follow-up of the PARTNER 3 trial provides the most robust randomized evidence comparing balloon-expandable transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis at low surgical risk. Although early analyses demonstrated noninferiority of TAVI, longer-term data reveal temporal heterogeneity of treatment effects, nonproportional hazards, and interpretative dependence on composite endpoint structure. While the primary non-hierarchical composite endpoint shows no statistically significant difference at seven years, all-cause mortality is numerically higher in the TAVI group (19.5 vs. 16.8%). Hazard ratios converge and appear to invert beyond the first year, and restricted mean survival time analyses integrate early benefit with late-phase attenuation. This Point of View examines the methodological and temporal architecture of the 7-year analysis and discusses its implications for durability assessment and long-term decision-making in low-risk patients with extended life expectancy.


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