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Win ratio analysis of the LANDMARK trial
Akihiro Tobe1, Niels van Royen2, Ignacio J Amat-Santos3
1Department of Cardiology, School of Medicine, University of Galway, Galway, Ireland.
American Heart Journal
|May 2, 2025
Summary
The Myval transcatheter heart valve (THV) showed non-inferiority against standard THVs in severe aortic stenosis patients. This study further analyzed their comparative performance using a novel win ratio approach.
Area of Science:
- Cardiology
- Biomedical Engineering
- Clinical Trials
Background:
- Severe aortic stenosis necessitates intervention, with transcatheter heart valves (THVs) offering a less invasive option.
- The Myval THV series has emerged as an alternative to established THV systems.
- Previous trials established the non-inferiority of Myval THV against contemporary standards for a 30-day endpoint.
Purpose of the Study:
- To conduct an exploratory comparison of the Myval THV series against contemporary THV series (Sapien, Evolut).
- To evaluate and compare the performance of Myval THV using the win ratio analysis methodology.
Main Methods:
- Utilized data from the LANDMARK trial.
- Applied the win ratio analysis to compare Myval THV performance against Sapien and Evolut THV series.
- Focused on a composite endpoint and overall treatment effect.
Main Results:
- The win ratio analysis provided a more nuanced comparison of the THV series.
- Detailed performance metrics and comparative outcomes were assessed.
Conclusions:
- The Myval THV series demonstrates comparable performance to contemporary THV systems in severe aortic stenosis.
- Win ratio analysis offers valuable insights into comparative effectiveness of different THV technologies.
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