Asymptomatic versus Symptomatic Patients with Severe Aortic Stenosis View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-07-04

AUTHORS

Norio Kanamori, Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Makoto Miyake, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Kazuya Nagao, Tsukasa Inada, Hiroshi Mabuchi, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Toshikazu Jinnai, Yuko Morikami, Naritatsu Saito, Kenji Minatoya, Takeshi Aoyama, Takeshi Kimura, CURRENT AS registry Investigators

ABSTRACT

It is unknown how much different are the clinical outcomes between asymptomatic and symptomatic patients with severe aortic stenosis (AS). In the CURRENT AS registry enrolling 3,815 consecutive patients with severe AS, we compared the long-term outcomes between 1808 asymptomatic and 1215 symptomatic patients (exertional dyspnea: N = 813, syncope: N = 136, and angina: N = 266) without heart failure (HF) hospitalization. Symptomatic patients had greater AS severity, and more depressed left ventricular function than asymptomatic patients without much difference in other baseline characteristics. During a median follow-up of 3.2 years, aortic valve replacement (AVR) was performed in 62% of symptomatic patients, and 38% of asymptomatic patients. The cumulative 5-year incidences for the primary outcome measure (a composite of aortic valve-related death or HF hospitalization) was higher in symptomatic patients than in asymptomatic patients (32.3% versus 27.6%, P < 0.001). After adjusting for AVR and other variables, the greater risk of symptomatic relative to asymptomatic patients for the primary outcome measure was significant (hazard ratio 1.64, 95% confidence interval 1.41–1.96, P < 0.001). In conclusions, the excess risk of symptomatic relative to asymptomatic patients with severe AS for the aortic valve-related event was significant. However, the prevalence of AVR in symptomatic patients was not optimal. More... »

PAGES

10080

References to SciGraph publications

  • 2016-03-28. Erratum to: Thoracic and cardiovascular surgery in Japan: Annual Report by The Japanese Association for Thoracic Surgery in GENERAL THORACIC AND CARDIOVASCULAR SURGERY
  • 2016-09-02. Thoracic and cardiovascular surgery in Japan during 2014 in GENERAL THORACIC AND CARDIOVASCULAR SURGERY
  • Journal

    TITLE

    Scientific Reports

    ISSUE

    1

    VOLUME

    8

    Author Affiliations

  • Division of Cardiology, Shimada Municipal Hospital, Shimada, Japan
  • Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
  • Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
  • Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
  • Department of Cardiology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
  • Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
  • Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan
  • Department of Cardiology, Tenri Hospital, Tenri, Japan
  • Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan
  • Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan
  • Department of Cardiology, Kinki University Hospital, Osakasayama, Japan
  • Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan
  • Department of Cardiology, Koto Memorial Hospital, Higashiomi, Japan
  • Department of Cardiology, Shizuoka General Hospital, Shizuoka, Japan
  • Department of Cardiology, Nishikobe Medical Center, Kobe, Japan
  • Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
  • Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
  • Cardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
  • Department of Cardiology, Hikone Municipal Hospital, Hikone, Japan
  • Department of Cardiology, Kansai Electric Power Hospital, Osaka, Japan
  • Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
  • Department of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan
  • Department of Cardiology, Saiseikai Noe Hospital, Osaka, Japan
  • Department of Cardiology, Shiga Medical Center for Adults, Moriyama, Japan
  • Department of Cardiology, Hamamatsu Rosai Hospital, Hamamatsu, Japan
  • Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan
  • Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41598-018-28162-x

    DOI

    http://dx.doi.org/10.1038/s41598-018-28162-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1105228735

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29973671


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