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Title: Malignant disease as a comorbidity in patients with severe aortic stenosis: clinical presentation, outcomes, and management
Authors: Minamino-Muta, Eri
Kato, Takao
Morimoto, Takeshi
Taniguchi, Tomohiko
Nakatsuma, Kenji
Kimura, Yuki
Inoko, Moriaki
Shirai, Shinichi
Kanamori, Norio
Murata, Koichiro
Kitai, Takeshi
Kawase, Yuichi
Miyake, Makoto
Izumi, Chisato
Mitsuoka, Hirokazu
Hirano, Yutaka
Sasa, Tomoki
Nagao, Kazuya
Inada, Tsukasa
Nishikawa, Ryusuke
Takeuchi, Yasuyo
Yamagami, Shintaro
Yamane, Keiichiro
Su, Kanae
Komasa, Akihiro
Ishii, Katsuhisa
Yamashita, Yugo  kyouindb  KAKEN_id
Kato, Yoshihiro
Takabayashi, Kensuke
Saito, Naritatsu  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0001-9219-5279 (unconfirmed)
Minatoya, Kenji
Kimura, Takeshi  kyouindb  KAKEN_id
,  KAKEN_name
Author's alias: 南野, 恵理
加藤, 貴雄
谷口, 智彦
中妻, 賢志
山上, 新太郎
小正, 晃裕
山下, 侑吾
齋藤, 成達
木村, 剛
Keywords: Aortic stenosis
Malignancy
Cancer
Preoperative complications
Issue Date: 1-Jul-2018
Publisher: Oxford University Press (OUP)
Journal title: European Heart Journal - Quality of Care and Clinical Outcomes
Volume: 4
Issue: 3
Start page: 180
End page: 188
Abstract: [Aim]To investigate the effect of malignancy on the outcomes of patients with severe aortic stenosis (AS) and the management strategy for AS with malignancy. [Methods and results]Using data of 3815 patients with severe AS in a retrospective multicentre registry [CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) registry], we compared 3-year clinical outcomes among three groups based on malignancy status: with malignancy currently under treatment including best supportive care (malignancy group), with a history of malignancy without any current treatment (past history group), or without history of malignancy (no malignancy group). Patients in the malignancy group (n = 124) were more often men and had higher prevalence of low body mass index, recurrence of malignancy, anaemia, and asymptomatic status, despite comparable surgical risks and echocardiographic parameters. The malignancy group or the past history group (n = 389) had significantly higher risk for all-cause death [hazard ratio (HR) 2.49, 95% CI (95% confidence interval) 1.98–3.14; HR 1.23, 95% CI 1.04–1.46] and for malignancy-related death (HR 16.2, 95% CI 10.64–24.54; HR 3.66, 95% CI 2.43–5.52) than that of the no malignancy group (n = 3302). The excess risk for aortic valve-related death was not observed in the malignancy group (HR 0.79, 95% CI 0.48–1.29) and was lower in the past history group (HR 0.72, 95% CI 0.53–0.96). In the malignancy group, the treatment strategy (surgery: n = 16, conservative management: n = 108) was determined based on the clinical status of AS or life expectancy. [Conclusions]Malignancy had marked effect on all-cause death and malignancy-related death in patients with severe AS. History of malignancy also had a smaller but significant effect on mortality.
Rights: This is a pre-copyedited, author-produced PDF of an article accepted for publication in 'European Heart Journal - Quality of Care and Clinical Outcomes' following peer review. The version of record [European Heart Journal - Quality of Care and Clinical Outcomes, Volume 4, Issue 3, 1 July 2018, Pages 180–188, https://doi.org/10.1093/ehjqcco/qcy010] is available online at: https://academic.oup.com/ehjqcco/article/4/3/180/4955211
The full-text file will be made open to the public on 27 March 2019 in accordance with publisher's 'Terms and Conditions for Self-Archiving'.
This is not the published version. Please cite only the published version.
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
URI: http://hdl.handle.net/2433/236131
DOI(Published Version): 10.1093/ehjqcco/qcy010
PubMed ID: 29596567
Appears in Collections:Journal Articles

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