Outcomes in asymptomatic, severe aortic stenosis.
<h4>Background and aim of the study</h4>Patients with asymptomatic, severe aortic stenosis are presumed to have a benign prognosis. In this retrospective cohort study, we examined the natural history of contemporary patients advised against aortic valve replacement due to a perceived lac...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0249610 |
| _version_ | 1818406852527915008 |
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| author | Anette Borger Kvaslerud Kenan Santic Amjad Iqbal Hussain Andreas Auensen Arnt Fiane Helge Skulstad Lars Aaberge Lars Gullestad Kaspar Broch |
| author_facet | Anette Borger Kvaslerud Kenan Santic Amjad Iqbal Hussain Andreas Auensen Arnt Fiane Helge Skulstad Lars Aaberge Lars Gullestad Kaspar Broch |
| author_sort | Anette Borger Kvaslerud |
| collection | DOAJ |
| description | <h4>Background and aim of the study</h4>Patients with asymptomatic, severe aortic stenosis are presumed to have a benign prognosis. In this retrospective cohort study, we examined the natural history of contemporary patients advised against aortic valve replacement due to a perceived lack of symptoms.<h4>Materials and methods</h4>We reviewed the medical records of every patient given the ICD-10-code for aortic stenosis (I35.0) at Oslo University Hospital, Rikshospitalet, between Dec 1st, 2002 and Dec 31st, 2016. Patients who were evaluated by the heart team due to severe aortic stenosis were categorized by treatment strategy. We recorded baseline data, adverse events and survival for the patients characterized as asymptomatic and for 100 age and gender matched patients scheduled for aortic valve replacement.<h4>Results</h4>Of 2341 patients who were evaluated for aortic valve replacement due to severe aortic stenosis, 114 patients received conservative treatment due to a lack of symptoms. Asymptomatic patients had higher mortality than patients who had aortic valve replacement, log-rank p<0.001 (mean follow-up time: 4.0 (SD: 2.5) years). Survival at 1, 2 and 3 years for the asymptomatic patients was 88%, 75% and 63%, compared with 92%, 83% and 78% in the matched patients scheduled for aortic valve replacement. 28 (25%) of the asymptomatic patients had aortic valve replacement during follow-up. Age, previous history of coronary artery disease and N-terminal pro B-type natriuretic peptide (NT-proBNP) were predictors of mortality and coronary artery disease and NT-proBNP were predictors of 3-year morbidity in asymptomatic patients.<h4>Conclusions</h4>In this retrospective study, asymptomatic patients with severe aortic stenosis who were advised against surgery had significantly higher mortality than patients who had aortic valve replacement. |
| first_indexed | 2024-12-14T09:18:32Z |
| format | Article |
| id | doaj.art-19656fd76aa7433e87beb7b09ea1c6dc |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T09:18:32Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-19656fd76aa7433e87beb7b09ea1c6dc2022-12-21T23:08:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01164e024961010.1371/journal.pone.0249610Outcomes in asymptomatic, severe aortic stenosis.Anette Borger KvaslerudKenan SanticAmjad Iqbal HussainAndreas AuensenArnt FianeHelge SkulstadLars AabergeLars GullestadKaspar Broch<h4>Background and aim of the study</h4>Patients with asymptomatic, severe aortic stenosis are presumed to have a benign prognosis. In this retrospective cohort study, we examined the natural history of contemporary patients advised against aortic valve replacement due to a perceived lack of symptoms.<h4>Materials and methods</h4>We reviewed the medical records of every patient given the ICD-10-code for aortic stenosis (I35.0) at Oslo University Hospital, Rikshospitalet, between Dec 1st, 2002 and Dec 31st, 2016. Patients who were evaluated by the heart team due to severe aortic stenosis were categorized by treatment strategy. We recorded baseline data, adverse events and survival for the patients characterized as asymptomatic and for 100 age and gender matched patients scheduled for aortic valve replacement.<h4>Results</h4>Of 2341 patients who were evaluated for aortic valve replacement due to severe aortic stenosis, 114 patients received conservative treatment due to a lack of symptoms. Asymptomatic patients had higher mortality than patients who had aortic valve replacement, log-rank p<0.001 (mean follow-up time: 4.0 (SD: 2.5) years). Survival at 1, 2 and 3 years for the asymptomatic patients was 88%, 75% and 63%, compared with 92%, 83% and 78% in the matched patients scheduled for aortic valve replacement. 28 (25%) of the asymptomatic patients had aortic valve replacement during follow-up. Age, previous history of coronary artery disease and N-terminal pro B-type natriuretic peptide (NT-proBNP) were predictors of mortality and coronary artery disease and NT-proBNP were predictors of 3-year morbidity in asymptomatic patients.<h4>Conclusions</h4>In this retrospective study, asymptomatic patients with severe aortic stenosis who were advised against surgery had significantly higher mortality than patients who had aortic valve replacement.https://doi.org/10.1371/journal.pone.0249610 |
| spellingShingle | Anette Borger Kvaslerud Kenan Santic Amjad Iqbal Hussain Andreas Auensen Arnt Fiane Helge Skulstad Lars Aaberge Lars Gullestad Kaspar Broch Outcomes in asymptomatic, severe aortic stenosis. PLoS ONE |
| title | Outcomes in asymptomatic, severe aortic stenosis. |
| title_full | Outcomes in asymptomatic, severe aortic stenosis. |
| title_fullStr | Outcomes in asymptomatic, severe aortic stenosis. |
| title_full_unstemmed | Outcomes in asymptomatic, severe aortic stenosis. |
| title_short | Outcomes in asymptomatic, severe aortic stenosis. |
| title_sort | outcomes in asymptomatic severe aortic stenosis |
| url | https://doi.org/10.1371/journal.pone.0249610 |
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