High- Versus Low-Gradient Severe Aortic Stenosis: Demographics, Clinical Outcomes, and Effects of the Initial Aortic Valve Replacement Strategy on Long-Term Prognosis

Circulation. Cardiovascular Interventions
Tomohiko TaniguchiCURRENT AS Registry Investigators

Abstract

There is considerable debate on the management of patients with low-gradient severe aortic stenosis (LG-AS), defined as aortic valve area <1 cm2with peak aortic jet velocity ≤4.0 m/s, and mean aortic pressure gradient ≤40 mm Hg. In the CURRENT AS registry (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis), there were 2097 patients (initial aortic valve replacement [AVR] strategy: n=977, and conservative strategy: n=1120) with high-gradient severe aortic stenosis (HG-AS) and 1712 patients (initial AVR strategy: n=219, and conservative strategy: n=1493) with LG-AS. AVR was more frequently performed in HG-AS patients than in LG-AS patients (60% versus 28%) during the entire follow-up. In the comparison between the initial AVR and conservative groups, the propensity score-matched cohorts were developed in both HG-AS (n=887 for each group) and LG-AS (n=218 for each group) strata. The initial AVR strategy when compared with the conservative strategy was associated with markedly lower risk for a composite of aortic valve-related death or heart failure hospitalization in both HG-AS and LG-AS strata (hazard ratio, 0.30; 95% confidence interval, 0.25-0.37;P<0.001 and hazard ratio, 0.46; 95...Continue Reading

References

Aug 31, 2000·The New England Journal of Medicine·R RosenhekH Baumgartner
Dec 25, 2007·European Heart Journal·Jan MinnersNikolaus Jander
Feb 16, 2011·Circulation·Nikolaus JanderChrista Gohlke-Bärwolf
Jun 5, 2012·Journal of the American College of Cardiology·Marie-Annick ClavelPhilippe Pibarot
Aug 28, 2012·European Heart Journal·UNKNOWN Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC)Marian Zembala
Sep 23, 2014·Journal of the American College of Cardiology·Marie-Annick ClavelMaurice Enriquez-Sarano
Oct 20, 2015·Journal of the American College of Cardiology·Tomohiko TaniguchiUNKNOWN CURRENT AS Registry Investigators
Dec 17, 2015·Journal of the American College of Cardiology·Victor DayanPhilippe Pibarot
May 18, 2016·European Heart Journal·Marie-Annick ClavelPhilippe Pibarot

❮ Previous
Next ❯

Citations

Oct 13, 2017·Circulation. Cardiovascular Imaging·Philippe Pibarot, Marie-Annick Clavel
Dec 26, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiro KushiyamaUNKNOWN CURRENT AS Registry Investigators
Sep 13, 2019·Science Translational Medicine·Eyal Ben-AssaElazer R Edelman
Jul 6, 2018·Scientific Reports·Norio KanamoriUNKNOWN CURRENT AS registry Investigators
Aug 7, 2019·European Heart Journal. Quality of Care & Clinical Outcomes·Eri Minamino-MutaTakeshi Kimura
Jun 8, 2021·JACC. Basic to Translational Science·Philip SarajlicMagnus Bäck

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.