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Pearl Toh, 20 Nov 2019
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Moderate-to-severe aortic stenosis tied to poor survival when left untreated

17 Oct 2019

Long-term mortality remains high in patients with untreated severe aortic stenosis (AS), suggests a study. Those with moderate AS also have poor survival rates.

Of the patients, 16,129 (6.7 percent), 3,315 (1.4 percent) and 6,383 (2.6 percent) had mild, moderate and severe AS, respectively.

On an adjusted basis (compared with no AS; 5-year mortality, 19 percent), an increasing risk of long-term mortality was observed in patients with mild to severe AS (adjusted hazard ratio, 1.44–2.09; p<0.001 for all comparisons).

Patients with moderate AS (mean gradient, 20.0–39.0 mm Hg or peak velocity, 3.0–3.9 m/s) and severe AS (≥40.0 mm Hg, ≥4.0 m/s, or aortic valve area <1.0 cm2 in low-flow, low-gradient severe AS) had a corresponding 5-year mortality of 56 percent and 67 percent.

After adjusting for age, sex, aortic regurgitation, and left ventricular systolic or diastolic dysfunction, a significant increase in risk of death from all causes (5-year mortality >50 percent) and cardiovascular disease was observed in patients with moderate AS (mean aortic valve gradient >20.0 mm Hg).

This study characterized AS severity by convention and by statistical distribution in 122,809 male patients (mean age, 61 years) and 118,494 female patients (mean age, 62 years), with measured aortic valve mean gradient, peak velocity and/or area.

The authors assessed the association between AS severity and survival during a median follow-up of 1,208 days (interquartile range, 598–2,177 days). Patients with previous aortic valve intervention were not included in the analysis.

“Historical data suggesting poor survival in patients with AS who do not undergo treatment are largely confined to patients with severe AS,” the authors noted.

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Most Read Articles
Pearl Toh, 20 Nov 2019
The trade-off between the risk of ischaemic vs bleeding events may be different between Asian and non-Asian patients, which warrants careful consideration when deciding on the duration of antiplatelet therapy following a percutaneous coronary intervention (PCI), according to a presentation at ESC Asia Congress 2019.
3 days ago
Participating in a long-distance skiing event may help lower the risk of hypertension, with the number of completed races showing a weak association with the risk, a study has found.
06 Sep 2019
Hypertensive adults with lower plasma zinc concentration are at increased risk of haemorrhagic stroke, especially those with higher body mass index or lower plasma copper levels, a study has found.
06 Jan 2020
Target organ damage appears to be more noticeable in patients affected by primary aldosteronism than those affected by arterial hypertension without primary aldosteronism, suggests a study, adding that specific treatment can ease such condition.