Life Expectancy of Patients With Severe Aortic Stenosis in Relation to Age and Surgical Risk Score.

Autor:	Taniguchi T; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan., Morimoto T; Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan., Yamaji K; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan., Shirai S; Department of Cardiovascular Medicine, Kokura Memorial Hospital, Kitakyushu, Japan., Ando K; Department of Cardiovascular Medicine, Kokura Memorial Hospital, Kitakyushu, Japan., Shiomi H; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan., Takeji Y; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan., Ohno N; Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan., Kanamori N; Department of Cardiovascular Medicine, Shimada General Medical Center, Shimada, Japan., Yamazaki F; Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan., Koyama T; Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan., Kim K; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan., Ehara N; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan., Furukawa Y; Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan., Komiya T; Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan., Iwakura A; Department of Cardiovascular Surgery, Tenri Hospital, Tenri City, Japan., Shirotani M; Department of Cardiovascular Medicine, Kindai University Nara Hospital, Nara, Japan., Esaki J; Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, West Kyoto, Japan., Sakaguchi G; Department of Cardiovascular Surgery, Kindai University Hospital, Osaka Sayama City, Japan., Fujii K; Department of Cardiovascular Surgery, Kishiwada City Hospital, Kishiwada, Japan., Nakayama S; Department of Cardiovascular Surgery, Osaka Red Cross Hospital, Osaka, Japan., Mabuchi H; Department of Cardiovascular Medicine, Koto Memorial Hospital, Higashiomi, Japan., Tsuneyoshi H; Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan., Eizawa H; Department of Cardiovascular Medicine, Kobe City Nishi-Kobe Medical Center, Kobe, Japan., Shiraga K; Department of Cardiovascular Surgery, Kyoto Medical Center, Kyoto Japan., Hanyu M; Department of Cardiovascular Surgery, Kitano Hospital, Osaka, Japan., Nakano A; Department of Cardiovascular Medicine, Hikone Municipal Hospital, Hikone, Japan., Ishii K; Department of Cardiovascular Medicine, Kansai Electric Power Hospital, Fukushima, Japan., Tamura N; Department of Cardiovascular Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan., Higashitani N; Department of Cardiovascular Medicine, Otsu Red Cross Hospital, Otsu, Japan., Kouchi I; Department of Cardiovascular Medicine, Saiseikai Noe Hospital, Osaka, Japan., Yamada T; Department of Cardiovascular Surgery, Shiga General Hospital, Shiga, Japan., Nishizawa J; Department of Cardiovascular Surgery, Hamamatsu Rosai Hospital, Hamamatsu City, Japan., Jinnai T; Department of Cardiovascular Medicine, Otsu Red Cross Hospital, Otsu, Japan., Morikami Y; Department of Cardiovascular Medicine, Hirakata Kohsai Hospital, Hirakata, Japan., Minatoya K; Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Kimura T; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: taketaka@kuhp.kyoto-u.ac.jp.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2023 Dec; Vol. 116 (6), pp. 1195-1203. Date of Electronic Publication: 2023 Feb 02.
DOI:	10.1016/j.athoracsur.2023.01.028
Abstrakt:	Background: There is a paucity of data regarding shorter life expectancy after aortic valve replacement (AVR) in patients with severe aortic stenosis (AS). Methods: Among 3815 patients with severe AS enrolled in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) registry, there were 1469 patients (initial AVR: n = 647; conservative strategy: n = 822) with low surgical risk, 1642 patients (initial AVR: n = 433; conservative strategy: n = 1209) with intermediate surgical risk, and 704 patients (initial AVR: n = 117; conservative strategy: n = 587) with high surgical risk. Among 1163 patients who actually underwent surgical AVR as the initial strategy, patients were divided into 4 groups according to age <65 years (n = 185), 65 to 74 (n = 394), 75 to 80 (n = 345), and >80 (n = 239). The expected survival of the general Japanese population was obtained from the Statistics Bureau of Japan. The surgical risk was estimated using The Society of Thoracic Surgery (STS) score. Results: The median follow-up was 3.7 years. The cumulative incidences of all-cause death were significantly lower in the initial AVR strategy than in the initial conservative strategy across the 3 STS groups. Shorter life expectancy after surgical AVR was seen especially in younger patients. The observed mortality in low-risk patients was comparable to the expected mortality across all the age-groups, while intermediate-risk patients aged <75 years, and high-risk patients across all age-groups had higher mortality compared with the expected mortality. Conclusions: The risk stratification according to age and STS score might be useful to estimate shorter life expectancy after AVR, and these findings have implications for decision making in the choice of surgical or transcatheter AVR. (Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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