Impact of selected comorbidities on the presentation and management of aortic stenosis
Rudolph, Tanka K. (Ruhr-University of Bochum)
Messika-Zeitoun, David (University of Ottawa Heart Institute)
Frey, Norbert (University of Kiel)
Thambyrajah, Jeetendra (James Cook University Hospital)
Serra, Antonio (Institut d'Investigació Biomèdica Sant Pau)
Schulz, Eberhard (AKH Celle)
Maly, Jiri (Charles University)
Aiello, Marco (Foundation IRCCS Policlinico S.Matteo)
Lloyd, Guy (St Bartholomew's Hospital)
Bortone, Alessandro Santo (University of Bari)
Clerici, Alberto (University of Turin)
Delle-Karth, Georg (Hietzing Hospital)
Rieber, Johannes (University of Munich)
Indolfi, Ciro (Magna Graecia University)
Mancone, Massimo (Sapienza University of Rome)
Belle, Loic (Centre Hospital d'Annecy)
Lauten, Alexander (University Heart Center and Charité)
Arnold, Martin (University of Erlangen)
Bouma, Berto J. (University of Amsterdam)
Lutz, Matthias (University of Kiel)
Deutsch, Cornelia (Institute for Pharmacology and Preventive Medicine)
Kurucova, Jana (Edwards Lifesciences)
Thoenes, Martin (Edwards Lifesciences)
Bramlage, Peter (Institute for Pharmacology and Preventive Medicine)
Steeds, Richard (University of Birmingham)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	Contemporary data regarding the impact of comorbidities on the clinical presentation and management of patients with severe aortic stenosis (AS) are scarce. Prospective registry of severe patients with AS across 23 centres in nine European countries. Of the 2171 patients, chronic kidney disease (CKD 27. 3%), left ventricular ejection fraction (LVEF) <50% (22. 0%), atrial fibrillation (15. 9%) and chronic obstructive pulmonary disease (11. 4%) were the most prevalent comorbidities (49. 3% none, 33. 9% one and 16. 8% ≥2 of these). The decision to perform aortic valve replacement (AVR) was taken in a comparable proportion (67%, 72% and 69%, in patients with 0, 1 and ≥2 comorbidities; p=0. 186). However, the decision for TAVI was more common with more comorbidities (35. 4%, 54. 0% and 57. 0% for no, 1 and ≥2; p<0. 001), while the decision for surgical AVR (SAVR) was decreased with increasing comorbidity burden (31. 9%, 17. 4% and 12. 3%; p<0. 001). The proportion of patients with planned AVRs that were performed within 3 months was significantly higher in patients with 1 or ≥2 comorbidities than in those without (8. 7%, 10. 0% and 15. 7%; p<0. 001). Furthermore, the mean time to AVR was significantly shorter in patients with one (30. 5 days) or ≥2 comorbidities (30. 8 days) than in those without (35. 7 days; p=0. 012). Patients with reduced LVEF tended to be offered an AVR more frequently and with a shorter delay while patients with CKD were less frequently treated. Comorbidities in severe patients with AS affect the presentation and management of patients with severe AS. TAVI was offered more often than SAVR and performed within a shorter time period.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Aortic valve disease ; Cardiac surgery ; Prosthetic heart valves
Published in:	Open Heart, Vol. 7 Núm. 2 (23 2020) , p. e001271, ISSN 2053-3624

DOI: 10.1136/openhrt-2020-001271
PMID: 32709699

7 p, 610.3 KB

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Articles > Research articles
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