Key result
Major non-cardiac surgery significantly accelerated the hemodynamic progression of non-rheumatic aortic stenosis, increasing the odds of rapid progression by over 12-fold (OR 12.184).
Why the study?
Does major non-cardiac surgery accelerate the hemodynamic progression of non-rheumatic aortic stenosis in patients with non-rheumatic AS?
Cohort (n=138)
No
Does major non-cardiac surgery accelerate the hemodynamic progression of non-rheumatic aortic stenosis in patients with non-rheumatic AS?
Odds Ratio: 12.184 (95% CI 3.031–48.978)
Absolute Event Rate: 75% vs 20.6%
p-value: p=<0.001
Major non-cardiac surgery is independently associated with rapid hemodynamic progression of non-rheumatic aortic stenosis, highlighting the need for careful postoperative echocardiographic monitoring in these patients.
Supports closer postoperative echocardiographic surveillance in non-rheumatic AS; leaves open whether the association is causal and requires prospective confirmation.
BACKGROUND: Inflammatory processes are suggested to play a pathogenic role in the development and progression of non-rheumatic aortic stenosis (AS). Major surgery causes an inflammatory reaction. With the increasing prevalence of non-rheumatic AS, the number of affected patients undergoing major surgery increases. We hypothesized that major non-cardiac surgery (MNCS) could accelerate the progression of non-rheumatic AS. METHODS AND RESULTS: We enrolled 218 consecutive patients with non-rheumatic AS who underwent transthoracic echocardiography (TTE) at least twice more than 6 months apart. Study patients were divided into the MNCS group and the non-MNCS group. The MNCS group consisted of patients who underwent MNCS during the TTE follow-up interval. At baseline, peak pressure gradient across the aortic valve (AVG) was similar between the groups. Also baseline clinical characteristics and TTE follow-up interval were similar. The annual rate of peak AVG increase was much higher in the MNCS group than in the non-MNCS group. The proportion of patients with rapid hemodynamic progression was much higher in the MNCS group than in the non-MNCS group. Multiple logistic regression analysis showed that MNCS was an independent predictor of rapid hemodynamic progression of non-rheumatic AS. CONCLUSIONS: The present study indicates for the first time that MNCS is associated with the rapid progression of non-rheumatic AS.
No takes yet. Share an insight, caveat, or question.
Mizuno et al. (2015) conducted a cohort in Non-rheumatic aortic stenosis (n=138). Major non-cardiac surgery vs. No major non-cardiac surgery was evaluated on Rapid hemodynamic progression of aortic stenosis (annual rate of peak AVG increase in the highest quartile) (OR 12.184, 95% CI 3.031-48.978, p=<0.001). Major non-cardiac surgery significantly accelerated the hemodynamic progression of non-rheumatic aortic stenosis, increasing the odds of rapid progression by over 12-fold (OR 12.184).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: