Metabolic Syndrome Negatively Influences Disease Progression and Prognosis in Aortic Stenosis
| Autor: | Isabelle Lemieux, Jacques Couet, Marie Arsenault, Amélie Cartier, Jean-Pierre Després, Philippe Pibarot, Patrick Mathieu, Martin Briand, Jean G. Dumesnil |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Predictive Value of Tests Internal medicine medicine Humans 030212 general & internal medicine Prospective cohort study Survival analysis Aged Retrospective Studies Metabolic Syndrome Vascular disease business.industry Hemodynamics Retrospective cohort study Aortic Valve Stenosis Odds ratio Middle Aged Prognosis medicine.disease Survival Analysis Echocardiography Doppler 3. Good health Surgery Stenosis Aortic Valve Multivariate Analysis Disease Progression Cardiology Female Metabolic syndrome Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 47:2229-2236 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2005.12.073 |
| Popis: | Objectives This study sought to examine the association between the metabolic syndrome (MS) and the progression of aortic stenosis (AS). Background It has been suggested that aortic valve sclerosis and its progression to AS are caused by an atherosclerotic process. Metabolic syndrome is associated with a higher risk of vascular atherosclerosis. Thus, we hypothesized that the atherogenic features of MS could negatively influence disease progression and prognosis in patients with AS. Methods We retrospectively analyzed the data of 105 consecutive patients (age 69 ± 12 years, 64 men) with at least moderate AS. Of these patients, 40 (38%) had MS identified according to the modified clinical criteria proposed by the National Cholesterol Education Program-Adult Treatment Panel III. The hemodynamic progression of AS was assessed by the measurement of the annualized decrease in valve area during the follow-up period of the study, which averaged 28 ± 13 months. Event-free survival was defined as the absence of death or aortic valve replacement during follow-up. Results The hemodynamic progression of the stenosis was twice as fast (−0.14 ± 0.13 cm2/year vs. −0.08 ± 0.08 cm2/year, p = 0.008) and the three-year event-free survival was markedly lower (44 ± 8% vs. 69 ± 6%, p = 0.002) among patients with MS. In multivariate analysis, MS was found to be a strong independent predictor of both stenosis progression (p = 0.006) and event-free survival (odds ratio 3.85, 95% CI 1.96 to 7.58, p Conclusions The present study is the first to report that MS is associated with a faster disease progression and worse outcome in patients with AS. Such findings open new avenues of research and provide a strong impetus for the elaboration of additional prospective studies focusing on this association. |
| Databáze: | OpenAIRE |
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