Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
NCT04204915

The Early Valve Replacement in Severe ASYmptomatic Aortic Stenosis Study

Led by University of Leicester · Updated on 2025-09-25

2844

Participants Needed

110

Research Sites

577 weeks

Total Duration

On this page

Sponsors

U

University of Leicester

Lead Sponsor

U

University of Auckland, New Zealand

Collaborating Sponsor

AI-Summary

What this Trial Is About

Aortic stenosis (AS) affects approximately 5% of individuals \>65 years old, with \~3% of people \>75 years having moderate to severe disease. The prevalence of AS is rising rapidly due to an ageing population and is projected to double in the next two decades. Increasingly clinicians face the dilemma of how to best manage this growing population of mainly elderly patients, many of whom are asymptomatic but have been identified as having severe AS, often as an incidental finding. Reduced aortic valve opening progresses over decades without any apparent symptoms because the heart compensates for the AS. Ultimately, compensatory mechanisms fail resulting in angina, syncope or heart failure. If these symptomatic patients with severe AS remain untreated, they have a dire prognosis. In this situation the only effective treatment is AVR, either surgically or using TAVI. Conversely, conventional teaching and clinical practice in cardiology has been that, in the absence of symptoms, the prognosis is usually excellent and, except in a few very specific circumstances, conservative management and regular review (expectant management) is recommended. This advice is reflected in current international guidelines but is based largely on historical precedent. There has never been a randomised controlled trial to address the relative benefits of early AVR versus expectant management in patients with severe asymptomatic AS. The relative benefits of a strategy of early AVR/TAVI versus expectant management in patients with asymptomatic severe AS are unclear. There is clinical equipoise but it remains one of the few areas of cardiovascular medicine where no randomised controlled trials (RCT) have been performed. The EASY-AS study will provide crucial data on the relative merits of these differing approaches to management, in terms of important patient orientated outcomes, conventional cardiovascular end-points and cost effectiveness.

CONDITIONS

Official Title

The Early Valve Replacement in Severe ASYmptomatic Aortic Stenosis Study

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age over 18 years
  • Severe asymptomatic aortic stenosis as defined by specific valve measurements and calcium scores
  • Treating cardiologist agrees that either ongoing surveillance or early AVR is appropriate
  • Suitable for aortic valve replacement (surgical or TAVI) with acceptable risk
  • Willing to provide informed consent and be randomized to early AVR or expectant management
  • Ability to understand study materials or have access to a translator
Not Eligible

You will not qualify if you...

  • Symptoms related to aortic stenosis
  • Additional severe valvular heart disease
  • Planned other cardiac surgery before randomization (e.g., CABG)
  • Left ventricular systolic dysfunction with ejection fraction less than 50%
  • Pregnancy
  • Co-morbid condition limiting life expectancy to less than 2 years
  • Previous aortic valve replacement or TAVI with restenosis

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 110 locations

1

Canberra Hospital

Garran, Australian Capital Territory, Australia, 2605

Actively Recruiting

2

Liverpool Hospital

Liverpool, New South Wales, Australia, 2170

Actively Recruiting

3

Royal North Shore Hospital

St Leonards, New South Wales, Australia, 2065

Actively Recruiting

4

Westmead Hospital

Westmead, New South Wales, Australia, 2145

Actively Recruiting

5

Wollongong Hospital

Wollongong, New South Wales, Australia, 2500

Actively Recruiting

6

Prince Charles Hospital

Chermside, Queensland, Australia, 4032

Actively Recruiting

7

Townsville Hospital

Douglas, Queensland, Australia, 4814

Actively Recruiting

8

The Gold Coast Hospital

Southport, Queensland, Australia, 4215

Actively Recruiting

9

Royal Adelaide Hospital

Adelaide, South Australia, Australia, 5000

Actively Recruiting

10

Flinders Medical Centre

Adelaide, South Australia, Australia, SA 5042

Actively Recruiting

11

Monash Health

Clayton, Victoria, Australia, 3168

Actively Recruiting

12

University Hospital Geelong

Geelong, Victoria, Australia, 3220

Actively Recruiting

13

Fiona Stanley Hospital

Perth, Western Australia, Australia, 6150

Actively Recruiting

14

Royal Perth Hospital

Perth, Western Australia, Australia, WA6000

Actively Recruiting

15

Lyell McEwin Hospital

Elizabeth Vale, Australia, SA 5112

Actively Recruiting

16

Northern Hospital

Epping, Australia, VIC 3076

Actively Recruiting

17

Royal Hobart Hospital

Hobart, Australia, TAS 7000

Actively Recruiting

18

Nepean Hospital

Kingswood, Australia, NSW 2747

Actively Recruiting

19

John Hunter Hospital

New Lambton Heights, Australia, NSW 2305

Actively Recruiting

20

Royal Darwin Hospital

Tiwi, Australia, TIWI NT 0810

Actively Recruiting

21

Sint-Jan Hospital

Bruges, Belgium, 8000

Actively Recruiting

22

Ziekenhuis Oost-Limburg

Genk, Belgium, 3600

Actively Recruiting

23

University Hospital of Brussels

Jette, Belgium, 1090

Actively Recruiting

24

Frisius Medical Center

Leeuwarden, Netherlands

Actively Recruiting

25

Radboud University Medical Center

Nijmegen, Netherlands

Actively Recruiting

26

Auckland City Hospital

Auckland, New Zealand, 1023

Actively Recruiting

27

Christchurch Hospital

Christchurch, New Zealand, 8011

Actively Recruiting

28

Dunedin Hospital

Dunedin, New Zealand, 9016

Actively Recruiting

29

Institute of Cardiovascular Diseases

Kamenitz, Serbia, 21204

Actively Recruiting

30

Hospital Germans Trias

Barcelona, Spain

Actively Recruiting

31

University Hospital of Navarra

Pamplona, Spain

Actively Recruiting

32

University Hospital of North Durham

Durham, County Durham, United Kingdom, DH1 5TW

Actively Recruiting

33

Glan Clwyd Hospital

Bodelwyddan, Denbighshire, United Kingdom, LL18 5UJ

Actively Recruiting

34

Dorset County Hospital

Dorchester, Dorset, United Kingdom, DT1 2JY

Withdrawn

35

Basingstoke and North Hampshire Hospital

Basingstoke, Hampshire, United Kingdom, RG24 9NA

Actively Recruiting

36

University Hospitals Leicester, Glenfield

Leicester, Leicestershire, United Kingdom, LE3 9QP

Actively Recruiting

37

Royal Liverpool Hospital

Liverpool, Merseyside, United Kingdom, L7 8YE

Actively Recruiting

38

Norfolk and Norwich University Hospital

Norwich, Norfolk, United Kingdom, NR4 7UY

Actively Recruiting

39

Scunthorpe General Hospital

Scunthorpe, North Lincolnshire, United Kingdom, DN15 7BH

Actively Recruiting

40

Kettering General Hospital

Kettering, Northamptonshire, United Kingdom, NN16 8UZ

Actively Recruiting

41

Wansbeck General Hospital

Ashington, Northumberland, United Kingdom, NE63 9JJ

Actively Recruiting

42

Raigmore Hospital

Inverness, Scotland, United Kingdom, IV2 3UJ

Actively Recruiting

43

Musgrove Park Hospital

Taunton, Somerset, United Kingdom, TA1 5DA

Actively Recruiting

44

Morriston Hospital

Swansea, Wales, United Kingdom, SA6 6NL

Actively Recruiting

45

Russells Hall Hospital

Dudley, West Midlands, United Kingdom, DY1 2HQ

Actively Recruiting

46

George Eliot Hospital

Nuneaton, West Midlands, United Kingdom, CV10 7DJ

Actively Recruiting

47

Walsall Manor Hospital

Walsall, West Midlands, United Kingdom, WS2 9PS

Actively Recruiting

48

Sandwell General Hospital

West Bromwich, West Midlands, United Kingdom, B71 4HJ

Actively Recruiting

49

Wycombe Hospital

High Wycombe, Wycombe, United Kingdom, HP11 2TT

Actively Recruiting

50

Aberdeen Royal Infirmary

Aberdeen, United Kingdom, AB25 2ZN

Actively Recruiting

51

Aintree University Hospital

Aintree, United Kingdom, L9 7AL

Actively Recruiting

52

University Hospital Ayr

Ayr, United Kingdom, KA6 6DX

Actively Recruiting

53

Barnsley Hospital NHS Foundation Trust

Barnsley, United Kingdom

Actively Recruiting

54

Basildon University Hospital

Basildon, United Kingdom, SS16 5NL

Actively Recruiting

55

Queen Elizabeth Hospital

Birmingham, United Kingdom, B15 2GW

Actively Recruiting

56

Blackpool Victoria Hospital

Blackpool, United Kingdom, FY3 8NR

Actively Recruiting

57

Royal Sussex County Hospital

Brighton, United Kingdom, BN2 5BE

Actively Recruiting

58

North Cumbria Integrated Care

Carlisle, United Kingdom, CA2 7AF

Actively Recruiting

59

Chesterfield Royal Hospital

Chesterfield, United Kingdom, S44 5BL

Actively Recruiting

60

University Hospital Coventry & Warwickshire

Coventry, United Kingdom, CV2 2DX

Actively Recruiting

61

County Durham and Darlington NHS Foundation Trust

Darlington, United Kingdom, DL3 6HX

Actively Recruiting

62

Doncaster Royal Infirmary

Doncaster, United Kingdom, DN2 5LT

Actively Recruiting

63

Ninewells Hospital

Dundee, United Kingdom

Actively Recruiting

64

The Royal Infirmary of Edinburgh

Edinburgh, United Kingdom, EH16 4SA

Actively Recruiting

65

Royal Devon & Exeter Hospital

Exeter, United Kingdom, EX2 5DW

Actively Recruiting

66

Gateshead Health NHS Foundation Trust

Gateshead, United Kingdom, NE9 6SX

Actively Recruiting

67

Golden Jubilee National Hospital

Glasgow, United Kingdom, G81 4DY

Actively Recruiting

68

Glasgow Royal Infirmary

Glasgow, United Kingdom

Actively Recruiting

69

Queen Elizabeth University Hospital

Glasgow, United Kingdom

Actively Recruiting

70

Gloucestershire Hospitals NHS Foundation

Gloucester, United Kingdom

Actively Recruiting

71

Huddersfield Royal Infirmary

Huddersfield, United Kingdom, HD3 3EA

Actively Recruiting

72

West Middlesex University Hospital

Isleworth, United Kingdom, TW7 6AF

Actively Recruiting

73

Airedale General Hospital

Keighley, United Kingdom, BD20 6TD

Actively Recruiting

74

University Hospital Crosshouse

Kilmarnock, United Kingdom, KA2 0BE

Actively Recruiting

75

Leeds General Infirmary

Leeds, United Kingdom, LS1 3EX

Actively Recruiting

76

Lincoln County Hospital

Lincoln, United Kingdom, LN2 5QY

Actively Recruiting

77

Liverpool Heart and Chest Hospital

Liverpool, United Kingdom, L14 3PE

Actively Recruiting

78

Royal Liverpool Hospital

Liverpool, United Kingdom, L7 8XP

Not Yet Recruiting

79

St Bartholomew's Hospital

London, United Kingdom, EC1A 7BE

Actively Recruiting

80

St Thomas' Hospital

London, United Kingdom, SE1 7EH

Actively Recruiting

81

University Hospital Lewisham

London, United Kingdom, SE13 6LH

Actively Recruiting

82

Chelsea and Westminster Hospital

London, United Kingdom, SW10 9NH

Actively Recruiting

83

St George's Hospital

London, United Kingdom, SW17 0QT

Actively Recruiting

84

Cleveland Clinic London Hospital

London, United Kingdom, SW1X 7HY

Actively Recruiting

85

Imperial College Healthcare NHS Trust

London, United Kingdom

Actively Recruiting

86

Maidstone & Tunbridge Wells Hospital

Maidstone, United Kingdom, ME16 9QQ

Actively Recruiting

87

Wythenshawe Hospital

Manchester, United Kingdom, M23 9LT

Actively Recruiting

88

North Manchester General Hospital

Manchester, United Kingdom, M8 5RB

Actively Recruiting

89

The James Cook University Hospital

Middlesbrough, United Kingdom, TS4 3BW

Actively Recruiting

90

Freeman Hospital

Newcastle upon Tyne, United Kingdom, NE7 7DN

Actively Recruiting

91

Kings Mill Hospital

Nottingham, United Kingdom, NG17 4JL

Actively Recruiting

92

Queens Medical Centre

Nottingham, United Kingdom, NG7 2UH

Actively Recruiting

93

Royal Alexandra Hospital

Paisley, United Kingdom, PA2 9PN

Actively Recruiting

94

Derriford Hospital

Plymouth, United Kingdom, PL6 8DH

Actively Recruiting

95

Poole Hospital

Poole, United Kingdom, BH15 2JB

Actively Recruiting

96

Queen Alexandra Hospital

Portsmouth, United Kingdom, PO6 3LY

Actively Recruiting

97

Northern General Hospital

Sheffield, United Kingdom, S5 7AU

Actively Recruiting

98

Southampton General Hospital

Southampton, United Kingdom, SO16 6YD

Actively Recruiting

99

Forth Valley Royal Hospital

Stirling, United Kingdom, FK9 4SW

Actively Recruiting

100

Stepping Hill Hospital

Stockport, United Kingdom, SK2 7JE

Actively Recruiting

101

North Tees and Hartlepool NHS Foundation Trust

Stockton-on-Tees, United Kingdom, TS19 8PE

Actively Recruiting

102

South Tyneside and Sunderland NHS Foundation Trust

Sunderland, United Kingdom

Actively Recruiting

103

Torbay Hospital

Torquay, United Kingdom, TQ2 7AA

Actively Recruiting

104

Royal Cornwall Hospital

Truro, United Kingdom, TR1 3LJ

Actively Recruiting

105

Pinderfields Hospital

Wakefield, United Kingdom, WF1 4DG

Actively Recruiting

106

South Warwickshire University NHS Foundation Trust

Warwick, United Kingdom

Actively Recruiting

107

Watford General Hospital

Watford, United Kingdom, WD18 0HB

Actively Recruiting

108

New Cross Hospital

Wolverhampton, United Kingdom

Actively Recruiting

109

Worcester Acute Hospitals NHS FT

Worcester, United Kingdom

Actively Recruiting

110

Yeovil District Hospital

Yeovil, United Kingdom, BA21 4AT

Withdrawn

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Research Team

C

Carla Richardson

CONTACT

M

Michael Walters

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

PREVENTION

Number of Arms

2

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