Effect of Asymptomatic Severe Aortic Stenosis on Outcomes of Individuals Aged 80 and Older

Journal of the American Geriatrics Society
Atsuko SuzukiAkihiko Nogami

Abstract

To examine the effect of asymptomatic severe aortic stenosis (AS) on mortality late in life. Retrospective cohort study. Large medical center. 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. Information was collected on demographic characteristics, comorbidities, and laboratory and echocardiographic data. Survival was assessed according to longest follow-up available. 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). Asymptomatic ...Continue Reading

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Citations

Apr 27, 2020·European Heart Journal Cardiovascular Imaging·Kalie KebedRoberto M Lang

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