학술논문
Age-Related Differences in the Effects of Initial Aortic Valve Replacement vs. Conservative Strategy on Long-Term Outcomes in Asymptomatic Patients With Severe Aortic Stenosis
Document Type
Journal Article
Author
Akihiro Komasa; Akihiro Kushiyama; Chisato Izumi; Eri Minamino-Muta; Hirokazu Mitsuoka; Hiroki Shiomi; Hiroshi Mabuchi; Katsuhisa Ishii; Kazuya Nagao; Keiichiro Yamane; Kenji Ando; Kenji Minatoya; Koichiro Murata; Kozo Hotta; Makoto Miyake; Mamoru Toyofuku; Masashi Kato; Mitsuru Ishii; Moriaki Inoko; Naritatsu Saito; Nobuya Higashitani; Norio Kanamori; Shintaro Matsuda; Takao Kato; Takeshi Kimura; Takeshi Kitai; Takeshi Morimoto; Tomohiko Taniguchi; Tomoyuki Ikeda; Toshikazu Jinnai; Tsukasa Inada; Yasutaka Inuzuka; Yasuyo Takeuchi; Yoshihiro Kato; Yuichi Kawase; Yuko Morikami; Yutaka Hirano; on behalf of the CURRENT AS Registry Investigators
Source
Circulation Journal. 2020, 84(2):252
Subject
Language
English
ISSN
1346-9843
1347-4820
1347-4820
Abstract
Methods and Results:Among 1,808 asymptomatic severe AS patients in the CURRENT AS registry, there were 1,166 patients aged ≥75 years (initial AVR: n=124, and conservative: n=1,042), and 642 patients with age <75 years (initial AVR: n=167, and conservative: n=475). Median follow-up interval was 1,280 (interquartile range [IQR]: 1,012–1,611) days, and 1461 (IQR: 1,132–1,886) days in patients aged ≥ and <75 years, respectively. The favorable effect of the initial AVR strategy relative to conservative strategy for heart failure (HF) hospitalization was seen regardless of the age stratum (≥75 years: adjusted hazard ratio [HR] 0.13, 95% confidence interval [CI] 0.05–0.34, and <75 years: HR 0.37, 95% CI 0.14–0.99, interaction P=0.35). However, the lower mortality risk of the initial AVR strategy relative to conservative strategy was significant in patients aged ≥75 years, but not in patients <75 years, with significant interaction (HR 0.35, 95% CI 0.20–0.61, and HR 0.69, 95% CI 0.41–1.16, interaction P=0.016).