Moderate or severe valvular heart disease significantly increased the risk of all-cause mortality (HR 1.33) compared to no or mild valvular heart disease in patients with chronic coronary syndrome.
Cohort (n=1,984)
Yes
Does moderate or severe valvular heart disease increase all-cause mortality in patients with chronic coronary syndrome?
In patients with chronic coronary syndrome, moderate or severe valvular heart disease is independently associated with increased mortality, emphasizing the need for comprehensive echocardiographic assessment beyond just left ventricular function.
Effect estimate: HR 1.33 (95% CI 1.02-1.72)
p-value: p=0.03
Background: The European Society of Cardiology 2019 Guidelines on chronic coronary syndrome (CCS) recommend echocardiographic measurement of the left ventricular function for risk stratification in all patients with CCS. Whereas CCS and valvular heart disease (VHD) share common pathophysiological pathways and risk factors, data on the impact of VHD in CCS patients are scarce. Methods: Clinical data including treatment and mortality of patients diagnosed with CCS who underwent comprehensive transthoracic echocardiography (TTE) in two tertiary centers were collected. The outcome was all-cause mortality. Data were analyzed with Kaplan-Meier curves and Cox proportional hazard analysis adjusting for significant covariables and time-dependent treatment. Results: Between 2014 and 2021 a total of 1,984 patients with CCS (59% men) with a median age of 65 years (interquartile range IQR 57-73) underwent comprehensive TTE. Severe VHD was present in 44 patients and moderate VHD in 325 patients. A total of 654 patients (33%) were treated with revascularization, 39 patients (2%) received valve repair or replacement and 299 patients (15%) died during the median follow-up time of 3.5 years (IQR 1.7-5.6). Moderate or severe VHD (hazard ratio = 1.33; 95% CI 1.02-1.72) was significantly associated with mortality risk, independent of LV function and other covariables, as compared to no/mild VHD. Conclusions: VHD has a significant impact on mortality in patients with CCS additional to LV dysfunction, which emphasizes the need for a comprehensive echocardiographic assessment in these patients.
Molenaar et al. (Fri,) conducted a cohort in Chronic coronary syndrome (n=1,984). Moderate or severe valvular heart disease vs. No or mild valvular heart disease was evaluated on All-cause mortality (HR 1.33, 95% CI 1.02-1.72, p=0.03). Moderate or severe valvular heart disease significantly increased the risk of all-cause mortality (HR 1.33) compared to no or mild valvular heart disease in patients with chronic coronary syndrome.