Patients with moderate aortic stenosis had a relative survival rate of 86% compared to the general population, indicating an unfavorable disease course.
Does moderate aortic stenosis reduce survival compared to the general population in asymptomatic adults with preserved ejection fraction?
Moderate aortic stenosis is not a benign condition, as it is associated with significantly lower survival compared to the age- and sex-matched general population.
Absolute Event Rate: 0% vs 0%
Abstract Introduction Valvular heart diseases are not typically considered a major public health concern. However, rising life expectancy and an aging population are contributing to a growing prevalence of degenerative valve diseases. In clinical practice, moderate aortic stenosis (MAS) is often regarded as a relatively benign condition in terms of prognosis. Purpose To describe the incidence of mortality throughout the disease course in patients with moderate aortic stenosis (MAS) and to identify its prognostic factors. Methods This retrospective study included asymptomatic patients over 18 years old with isolated moderate aortic stenosis (MAS) or MAS associated with mild aortic regurgitation and preserved ejection fraction (50%). Patients with cardiomyopathies (ischemic-necrotic or other etiologies) or other mild-to-severe valvular heart diseases were excluded. The primary endpoint was all-cause mortality. Observed survival in patients with MAS was compared to the expected survival of the general population matched for age and sex. Relative survival was calculated as the ratio of observed to expected survival. Kaplan-Meier curves were used for graphical representation of survival, and an extended Cox model with a time-dependent covariate (aortic valve replacement) was estimated to identify prognostic factors for the primary endpoint. Results A total of 605 patients were included, with a mean follow-up of 3.75 years (SD ± 2.16). The median age was 80 years (IQR 75–85), and 46% were male. During follow-up, 103 patients (17%) underwent valve replacement, and 134 patients (22%) died. The relative survival rate was 86% of the expected rate for the general population, adjusted for age and sex. In the multivariate extended Cox model with a time-dependent covariate (aortic valve replacement), survival was associated with age, history of diabetes, stroke, cancer, left atrial volume, left ventricular ejection fraction, and baseline peak aortic velocity. Conclusion Elderly patients with MAS have an unfavorable disease course, as demonstrated by their lower relative survival compared to the general population. At the beginning of the follow-up, detection of prognostic factors of an adverse disease course allows us to identify patients at the greatest risk.
Iroulart et al. (Sat,) reported a other. Patients with moderate aortic stenosis had a relative survival rate of 86% compared to the general population, indicating an unfavorable disease course.