Poor Long-Term Survival in Patients With Moderate Aortic Stenosis
Historical data suggesting poor survival in patients with aortic stenosis (AS) who do not undergo treatment are largely confined to patients with severe AS. This study sought to determine the prognostic impact of all levels of native valvular AS. Severity of AS was characterized by convention and by...
Gespeichert in:
| Veröffentlicht in: | Journal of the American College of Cardiology 2019-10, Vol.74 (15), p.1851-1863 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1863 |
|---|---|
| container_issue | 15 |
| container_start_page | 1851 |
| container_title | Journal of the American College of Cardiology |
| container_volume | 74 |
| creator | Strange, Geoff Stewart, Simon Celermajer, David Prior, David Scalia, Gregory M. Marwick, Thomas Ilton, Marcus Joseph, Majo Codde, Jim Playford, David |
| description | Historical data suggesting poor survival in patients with aortic stenosis (AS) who do not undergo treatment are largely confined to patients with severe AS.
This study sought to determine the prognostic impact of all levels of native valvular AS.
Severity of AS was characterized by convention and by statistical distribution in 122,809 male patients (mean age 61 ± 17 years) and 118,494 female patients (mean age 62 ± 19 years), with measured aortic valve (AV) mean gradient, peak velocity, and/or area. The relationship between AS severity and survival was then examined during median 1,208 days (interquartile range: 598 to 2,177 days) of follow-up. Patients with previous aortic valve intervention were excluded.
Overall, 16,129 (6.7%), 3,315 (1.4%), and 6,383 (2.6%) patients had mild, moderate, and severe AS, respectively. On an adjusted basis (vs. no AS; 5-year mortality 19%), patients with mild to severe AS had an increasing risk of long-term mortality (adjusted hazard ratio: 1.44 to 2.09; p 20.0 mm Hg (moderate AS) after adjusting for age, sex, left ventricular systolic or diastolic dysfunction, and aortic regurgitation.
These data confirm that when left untreated, severe AS is associated with poor long-term survival. Moreover, they also suggest poor survival rates in patients with moderate AS. (National Echocardiographic Database of Australia [NEDA]; ACTRN12617001387314)
[Display omitted] |
| doi_str_mv | 10.1016/j.jacc.2019.08.004 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2286945648</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0735109719361923</els_id><sourcerecordid>2301824659</sourcerecordid><originalsourceid>FETCH-LOGICAL-c384t-fa2d7fd833015250dc3c8d81f6519b3f84d100dc2e90c266c0830af083ef6f0d3</originalsourceid><addsrcrecordid>eNp9kMGKFDEQhoMo7rj6Ah6kwYuXbitJJ5OAl2FZXWHEhV3xGLJJRdPMdNYkPeDbm2HWPXjwUgXFV38VHyGvKQwUqHw_DZN1bmBA9QBqABifkBUVQvVc6PVTsoI1Fz0FvT4jL0qZAEAqqp-TM05HTcUoV2RznVLutmn-0d9i3nc3Sz7Eg911ce6ubY0419J9j_Vn9yV5zLZit0m5RtfdVJxTieUleRbsruCrh35Ovn28vL246rdfP32-2Gx7x9VY-2CZXwevOAcqmADvuFNe0SAF1Xc8qNFTaFOGGhyT0oHiYEOrGGQAz8_Ju1PufU6_FizV7GNxuNvZGdNSDGNK6lHIUTX07T_olJY8t-8Ma-cVG6XQjWInyuVUSsZg7nPc2_zbUDBHwWYyR8HmKNiAMk1wW3rzEL3c7dE_rvw12oAPJwCbi0PEbIprFh36mNFV41P8X_4faq2KGw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2301824659</pqid></control><display><type>article</type><title>Poor Long-Term Survival in Patients With Moderate Aortic Stenosis</title><source>Access via ScienceDirect (Elsevier)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Strange, Geoff ; Stewart, Simon ; Celermajer, David ; Prior, David ; Scalia, Gregory M. ; Marwick, Thomas ; Ilton, Marcus ; Joseph, Majo ; Codde, Jim ; Playford, David</creator><creatorcontrib>Strange, Geoff ; Stewart, Simon ; Celermajer, David ; Prior, David ; Scalia, Gregory M. ; Marwick, Thomas ; Ilton, Marcus ; Joseph, Majo ; Codde, Jim ; Playford, David ; National Echocardiography Database of Australia contributing sites</creatorcontrib><description>Historical data suggesting poor survival in patients with aortic stenosis (AS) who do not undergo treatment are largely confined to patients with severe AS.
This study sought to determine the prognostic impact of all levels of native valvular AS.
Severity of AS was characterized by convention and by statistical distribution in 122,809 male patients (mean age 61 ± 17 years) and 118,494 female patients (mean age 62 ± 19 years), with measured aortic valve (AV) mean gradient, peak velocity, and/or area. The relationship between AS severity and survival was then examined during median 1,208 days (interquartile range: 598 to 2,177 days) of follow-up. Patients with previous aortic valve intervention were excluded.
Overall, 16,129 (6.7%), 3,315 (1.4%), and 6,383 (2.6%) patients had mild, moderate, and severe AS, respectively. On an adjusted basis (vs. no AS; 5-year mortality 19%), patients with mild to severe AS had an increasing risk of long-term mortality (adjusted hazard ratio: 1.44 to 2.09; p < 0.001 for all comparisons). The 5-year mortality was 56% and 67%, respectively, in those with moderate AS (mean gradient 20.0 to 39.0 mm Hg/peak velocity 3.0 to 3.9 m/s) and severe AS (≥40.0 mm Hg, ≥4.0 m/s, or AV area <1.0 cm2 in low-flow, low-gradient severe AS). A markedly increased risk of death from all causes (5-year mortality >50%) and cardiovascular disease was evident from a mean AV gradient >20.0 mm Hg (moderate AS) after adjusting for age, sex, left ventricular systolic or diastolic dysfunction, and aortic regurgitation.
These data confirm that when left untreated, severe AS is associated with poor long-term survival. Moreover, they also suggest poor survival rates in patients with moderate AS. (National Echocardiographic Database of Australia [NEDA]; ACTRN12617001387314)
[Display omitted]</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2019.08.004</identifier><identifier>PMID: 31491546</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Aortic stenosis ; Aortic valve ; Cardiology ; Cardiovascular disease ; Cardiovascular diseases ; cohort ; Data dictionaries ; Heart ; Mercury ; Mortality ; Regurgitation ; Stenosis ; Studies ; Survival ; Ultrasonic imaging ; Velocity ; Ventricle</subject><ispartof>Journal of the American College of Cardiology, 2019-10, Vol.74 (15), p.1851-1863</ispartof><rights>2019 American College of Cardiology Foundation</rights><rights>Copyright © 2019 American College of Cardiology Foundation. All rights reserved.</rights><rights>2019. American College of Cardiology Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-fa2d7fd833015250dc3c8d81f6519b3f84d100dc2e90c266c0830af083ef6f0d3</citedby><cites>FETCH-LOGICAL-c384t-fa2d7fd833015250dc3c8d81f6519b3f84d100dc2e90c266c0830af083ef6f0d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jacc.2019.08.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31491546$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Strange, Geoff</creatorcontrib><creatorcontrib>Stewart, Simon</creatorcontrib><creatorcontrib>Celermajer, David</creatorcontrib><creatorcontrib>Prior, David</creatorcontrib><creatorcontrib>Scalia, Gregory M.</creatorcontrib><creatorcontrib>Marwick, Thomas</creatorcontrib><creatorcontrib>Ilton, Marcus</creatorcontrib><creatorcontrib>Joseph, Majo</creatorcontrib><creatorcontrib>Codde, Jim</creatorcontrib><creatorcontrib>Playford, David</creatorcontrib><creatorcontrib>National Echocardiography Database of Australia contributing sites</creatorcontrib><title>Poor Long-Term Survival in Patients With Moderate Aortic Stenosis</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Historical data suggesting poor survival in patients with aortic stenosis (AS) who do not undergo treatment are largely confined to patients with severe AS.
This study sought to determine the prognostic impact of all levels of native valvular AS.
Severity of AS was characterized by convention and by statistical distribution in 122,809 male patients (mean age 61 ± 17 years) and 118,494 female patients (mean age 62 ± 19 years), with measured aortic valve (AV) mean gradient, peak velocity, and/or area. The relationship between AS severity and survival was then examined during median 1,208 days (interquartile range: 598 to 2,177 days) of follow-up. Patients with previous aortic valve intervention were excluded.
Overall, 16,129 (6.7%), 3,315 (1.4%), and 6,383 (2.6%) patients had mild, moderate, and severe AS, respectively. On an adjusted basis (vs. no AS; 5-year mortality 19%), patients with mild to severe AS had an increasing risk of long-term mortality (adjusted hazard ratio: 1.44 to 2.09; p < 0.001 for all comparisons). The 5-year mortality was 56% and 67%, respectively, in those with moderate AS (mean gradient 20.0 to 39.0 mm Hg/peak velocity 3.0 to 3.9 m/s) and severe AS (≥40.0 mm Hg, ≥4.0 m/s, or AV area <1.0 cm2 in low-flow, low-gradient severe AS). A markedly increased risk of death from all causes (5-year mortality >50%) and cardiovascular disease was evident from a mean AV gradient >20.0 mm Hg (moderate AS) after adjusting for age, sex, left ventricular systolic or diastolic dysfunction, and aortic regurgitation.
These data confirm that when left untreated, severe AS is associated with poor long-term survival. Moreover, they also suggest poor survival rates in patients with moderate AS. (National Echocardiographic Database of Australia [NEDA]; ACTRN12617001387314)
[Display omitted]</description><subject>Age</subject><subject>Aortic stenosis</subject><subject>Aortic valve</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>cohort</subject><subject>Data dictionaries</subject><subject>Heart</subject><subject>Mercury</subject><subject>Mortality</subject><subject>Regurgitation</subject><subject>Stenosis</subject><subject>Studies</subject><subject>Survival</subject><subject>Ultrasonic imaging</subject><subject>Velocity</subject><subject>Ventricle</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kMGKFDEQhoMo7rj6Ah6kwYuXbitJJ5OAl2FZXWHEhV3xGLJJRdPMdNYkPeDbm2HWPXjwUgXFV38VHyGvKQwUqHw_DZN1bmBA9QBqABifkBUVQvVc6PVTsoI1Fz0FvT4jL0qZAEAqqp-TM05HTcUoV2RznVLutmn-0d9i3nc3Sz7Eg911ce6ubY0419J9j_Vn9yV5zLZit0m5RtfdVJxTieUleRbsruCrh35Ovn28vL246rdfP32-2Gx7x9VY-2CZXwevOAcqmADvuFNe0SAF1Xc8qNFTaFOGGhyT0oHiYEOrGGQAz8_Ju1PufU6_FizV7GNxuNvZGdNSDGNK6lHIUTX07T_olJY8t-8Ma-cVG6XQjWInyuVUSsZg7nPc2_zbUDBHwWYyR8HmKNiAMk1wW3rzEL3c7dE_rvw12oAPJwCbi0PEbIprFh36mNFV41P8X_4faq2KGw</recordid><startdate>20191015</startdate><enddate>20191015</enddate><creator>Strange, Geoff</creator><creator>Stewart, Simon</creator><creator>Celermajer, David</creator><creator>Prior, David</creator><creator>Scalia, Gregory M.</creator><creator>Marwick, Thomas</creator><creator>Ilton, Marcus</creator><creator>Joseph, Majo</creator><creator>Codde, Jim</creator><creator>Playford, David</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20191015</creationdate><title>Poor Long-Term Survival in Patients With Moderate Aortic Stenosis</title><author>Strange, Geoff ; Stewart, Simon ; Celermajer, David ; Prior, David ; Scalia, Gregory M. ; Marwick, Thomas ; Ilton, Marcus ; Joseph, Majo ; Codde, Jim ; Playford, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-fa2d7fd833015250dc3c8d81f6519b3f84d100dc2e90c266c0830af083ef6f0d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Age</topic><topic>Aortic stenosis</topic><topic>Aortic valve</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>cohort</topic><topic>Data dictionaries</topic><topic>Heart</topic><topic>Mercury</topic><topic>Mortality</topic><topic>Regurgitation</topic><topic>Stenosis</topic><topic>Studies</topic><topic>Survival</topic><topic>Ultrasonic imaging</topic><topic>Velocity</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Strange, Geoff</creatorcontrib><creatorcontrib>Stewart, Simon</creatorcontrib><creatorcontrib>Celermajer, David</creatorcontrib><creatorcontrib>Prior, David</creatorcontrib><creatorcontrib>Scalia, Gregory M.</creatorcontrib><creatorcontrib>Marwick, Thomas</creatorcontrib><creatorcontrib>Ilton, Marcus</creatorcontrib><creatorcontrib>Joseph, Majo</creatorcontrib><creatorcontrib>Codde, Jim</creatorcontrib><creatorcontrib>Playford, David</creatorcontrib><creatorcontrib>National Echocardiography Database of Australia contributing sites</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Strange, Geoff</au><au>Stewart, Simon</au><au>Celermajer, David</au><au>Prior, David</au><au>Scalia, Gregory M.</au><au>Marwick, Thomas</au><au>Ilton, Marcus</au><au>Joseph, Majo</au><au>Codde, Jim</au><au>Playford, David</au><aucorp>National Echocardiography Database of Australia contributing sites</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Poor Long-Term Survival in Patients With Moderate Aortic Stenosis</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2019-10-15</date><risdate>2019</risdate><volume>74</volume><issue>15</issue><spage>1851</spage><epage>1863</epage><pages>1851-1863</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><abstract>Historical data suggesting poor survival in patients with aortic stenosis (AS) who do not undergo treatment are largely confined to patients with severe AS.
This study sought to determine the prognostic impact of all levels of native valvular AS.
Severity of AS was characterized by convention and by statistical distribution in 122,809 male patients (mean age 61 ± 17 years) and 118,494 female patients (mean age 62 ± 19 years), with measured aortic valve (AV) mean gradient, peak velocity, and/or area. The relationship between AS severity and survival was then examined during median 1,208 days (interquartile range: 598 to 2,177 days) of follow-up. Patients with previous aortic valve intervention were excluded.
Overall, 16,129 (6.7%), 3,315 (1.4%), and 6,383 (2.6%) patients had mild, moderate, and severe AS, respectively. On an adjusted basis (vs. no AS; 5-year mortality 19%), patients with mild to severe AS had an increasing risk of long-term mortality (adjusted hazard ratio: 1.44 to 2.09; p < 0.001 for all comparisons). The 5-year mortality was 56% and 67%, respectively, in those with moderate AS (mean gradient 20.0 to 39.0 mm Hg/peak velocity 3.0 to 3.9 m/s) and severe AS (≥40.0 mm Hg, ≥4.0 m/s, or AV area <1.0 cm2 in low-flow, low-gradient severe AS). A markedly increased risk of death from all causes (5-year mortality >50%) and cardiovascular disease was evident from a mean AV gradient >20.0 mm Hg (moderate AS) after adjusting for age, sex, left ventricular systolic or diastolic dysfunction, and aortic regurgitation.
These data confirm that when left untreated, severe AS is associated with poor long-term survival. Moreover, they also suggest poor survival rates in patients with moderate AS. (National Echocardiographic Database of Australia [NEDA]; ACTRN12617001387314)
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31491546</pmid><doi>10.1016/j.jacc.2019.08.004</doi><tpages>13</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0735-1097 |
| ispartof | Journal of the American College of Cardiology, 2019-10, Vol.74 (15), p.1851-1863 |
| issn | 0735-1097 1558-3597 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2286945648 |
| source | Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Age Aortic stenosis Aortic valve Cardiology Cardiovascular disease Cardiovascular diseases cohort Data dictionaries Heart Mercury Mortality Regurgitation Stenosis Studies Survival Ultrasonic imaging Velocity Ventricle |
| title | Poor Long-Term Survival in Patients With Moderate Aortic Stenosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T18%3A43%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Poor%20Long-Term%20Survival%20in%20Patients%20With%20Moderate%20Aortic%20Stenosis&rft.jtitle=Journal%20of%20the%20American%20College%20of%20Cardiology&rft.au=Strange,%20Geoff&rft.aucorp=National%20Echocardiography%20Database%20of%20Australia%20contributing%20sites&rft.date=2019-10-15&rft.volume=74&rft.issue=15&rft.spage=1851&rft.epage=1863&rft.pages=1851-1863&rft.issn=0735-1097&rft.eissn=1558-3597&rft_id=info:doi/10.1016/j.jacc.2019.08.004&rft_dat=%3Cproquest_cross%3E2301824659%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2301824659&rft_id=info:pmid/31491546&rft_els_id=S0735109719361923&rfr_iscdi=true |