학술논문
A risk prediction model in asymptomatic patients with severe aortic stenosis: CURRENT-AS risk score
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Academic Journal
Author
Minamino-Muta, Eri; Kato, Takao; Morimoto, Takeshi; Taniguchi, Tomohiko; Ando, Kenji; Kanamori, Norio; Murata, Koichiro; Kitai, Takeshi; Kawase, Yuichi; Miyake, Makoto; Izumi, Chisato; Mitsuoka, Hirokazu; Kato, Masashi; Hirano, Yutaka; Matsuda, Shintaro; Nagao, Kazuya; Murakami, Tomoyuki; Takeuchi, Yasuyo; Yamane, Keiichiro; Toyofuku, Mamoru; Ishii, Mitsuru; Inoko, Moriaki; Ikeda, Tomoyuki; Ishii, Katsuhisa; Hotta, Kozo; Jinnai, Toshikazu; Kato, Yoshihiro; Inuzuka, Yasutaka; Maeda, Chiyo; Morikami, Yuko; Saito, Naritatsu; Minatoya, Kenji; Kimura, Takeshi
Source
European Heart Journal: Quality of Care and Clinical Outcomes. April 2020, Vol. 6 Issue 2, p166, 9 p.
Subject
Language
English
ISSN
2058-5225
Abstract
Introduction Current guidelines generally recommend a strategy of watchful waiting until indications for aortic valve replacement (AVR) emerge in asymptomatic patients with severe aortic stenosis (AS), (1,2) because the potential [...]
Aims Early aortic valve replacement (AVR) might be beneficial in selected high-risk asymptomatic patients with severe aortic stenosis (AS), considering their poor prognosis when managed conservatively. This study aimed to develop and validate a clinical scoring system to predict AS-related events within1yearafterdiagnosisinasymptomaticsevereASpatients. Methods and results We analysed 1274 asymptomatic severe AS patients derived from a retrospective multicentre registry enrolling consecutive patients with severe AS in Japan (CURRENT AS registry), who were managed conservatively and completed 1-year follow-up without AVR. From a randomly assigned derivation set (N = 849), we developed CURRENT AS risk score for the AS-related event (a composite of AS-related death and heart failure hospitaliza-tion) within 1 year using a multivariable logistic regression model. The risk score comprised independent risk predictors including left ventricular ejection fraction 2 than in patients with score 4: 22.7%, P < 0.001). Conclusion The CURRENT-AS risk score integrating clinical and echocardiographic factors well-predicted the risk of AS-related events at 1 year in asymptomatic patients with severe AS and was validated internally. Keywords Severe aortic stenosis * Asymptomatic * Risk prediction model
Aims Early aortic valve replacement (AVR) might be beneficial in selected high-risk asymptomatic patients with severe aortic stenosis (AS), considering their poor prognosis when managed conservatively. This study aimed to develop and validate a clinical scoring system to predict AS-related events within1yearafterdiagnosisinasymptomaticsevereASpatients. Methods and results We analysed 1274 asymptomatic severe AS patients derived from a retrospective multicentre registry enrolling consecutive patients with severe AS in Japan (CURRENT AS registry), who were managed conservatively and completed 1-year follow-up without AVR. From a randomly assigned derivation set (N = 849), we developed CURRENT AS risk score for the AS-related event (a composite of AS-related death and heart failure hospitaliza-tion) within 1 year using a multivariable logistic regression model. The risk score comprised independent risk predictors including left ventricular ejection fraction 2 than in patients with score 4: 22.7%, P < 0.001). Conclusion The CURRENT-AS risk score integrating clinical and echocardiographic factors well-predicted the risk of AS-related events at 1 year in asymptomatic patients with severe AS and was validated internally. Keywords Severe aortic stenosis * Asymptomatic * Risk prediction model