Effect of Asymptomatic Severe Aortic Stenosis on Outcomes of Individuals Aged 80 and Older. Issue 9 (29th August 2018)

• Record Type: Journal Article
• Authors: Suzuki, Atsuko; Tajiri, Kazuko; Ishizu, Tomoko; Nakayama, Mio; Hoshi, Tomoya; Suzuki, Seiichi; Hatsutori, Mikiko; Sato, Noriko; Takayama, Shingo; Kawano, Mikihiko; Aonuma, Kazutaka; Nogami, Akihiko
• Is Part Of: Journal of the American Geriatrics Society. Volume 66:Issue 9(2018)
• Page Start: 1800
• Page End: 1804
• Publication Date: 2018-08-29
• Subjects: aortic stenosis -- prognosis -- asymptomatic; Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.15527
• Languages: English
• ISSNs: 0002-8614

Abstract

Abstract : Objectives: To examine the effect of asymptomatic severe aortic stenosis (AS) on mortality late in life. Design: Retrospective cohort study. Setting: Large medical center. Participants: Asymptomatic adults aged 80 and older (mean age 86 ± 4; N=1, 060, n=569 women) with preserved left ventricular ejection fraction (LVEF; > 50%); 927 (87.5%) with no AS, 70 (6.6%) with nonsevere AS, and 63 (5.9%) with severe AS. Measurements: Information was collected on demographic characteristics, comorbidities, and laboratory and echocardiographic data. Survival was assessed according to longest follow‐up available. Results: During a mean follow‐up of 2.2 ± 2.3 years, there were 203 (19%) deaths, 51 of which were from cardiovascular causes. Four‐year estimates of survival were 72% for no AS, 58% for nonsevere AS, and 23% for severe AS (p<.001). Univariable analysis showed that asymptomatic severe AS was significantly associated with greater risk of all‐cause mortality (hazard ratio (HR)=3.06, 95% confidence interval (CI)=1.96–4.58, p<.001). After adjustment for age, sex, LVEF, hypertension, dyslipidemia, diabetes, atrial fibrillation, chronic kidney disease, and coronary artery disease, asymptomatic severe AS was an independent predictor of all‐cause mortality (HR=3.16, 95% CI=1.97–4.88, p<.001). Conclusion: Asymptomatic severe AS has a major effect on prognosis even in very old adults.