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タイトル: | Five-Year Clinical Outcome of Asymptomatic vs. Symptomatic Severe Aortic Stenosis After Aortic Valve Replacement |
著者: | Shirai, Shinichi Taniguchi, Tomohiko Morimoto, Takeshi Ando, Kenji Korai, Kengo Minakata, Kenji Hanyu, Michiya Yamazaki, Fumio Koyama, Tadaaki Komiya, Tatsuhiko Kanamori, Norio Murata, Koichiro Kitai, Takeshi Kawase, Yuichi Izumi, Chisato Inada, Tsukasa Minamino-Muta, Eri Kato, Takao https://orcid.org/0000-0001-8213-7999 (unconfirmed) Inoko, Moriaki Ishii, Katsuhisa Saito, Naritatsu Yamanaka, Kazuo Nishiwaki, Noboru Nakajima, Hiroyuki Saga, Toshihiko Nakayama, Shogo Sakaguchi, Genichi Iwakura, Atsushi Shiraga, Kotaro Ueyama, Koji Miwa, Senri Fujiwara, Keiichi Nishizawa, Junichiro Kitano, Mitsuru Kitayama, Hitoshi Sakata, Ryuzo Kimura, Takeshi |
著者名の別形: | 谷口, 智彦 南方, 謙二 牟田, 恵里 加藤, 貴雄 齋藤, 成達 坂田 隆造 木村, 剛 |
キーワード: | Aortic stenosis Aortic valve replacement Outcome Valvular disease |
発行日: | Apr-2017 |
出版者: | Japanese Circulation Society |
誌名: | Circulation Journal |
巻: | 81 |
号: | 4 |
開始ページ: | 485 |
終了ページ: | 494 |
抄録: | Background:There is discordance regarding the effect of symptom status before aortic valve replacement (AVR) on long-term outcome after AVR in severe aortic stenosis (AS). Methods and Results:The CURRENT AS registry is a multicenter retrospective registry enrolling 3, 815 consecutive patients with severe AS. Among 1, 196 patients managed with the initial AVR strategy, long-term clinical outcomes were compared between the symptomatic patients (n=905), and asymptomatic patients (n=291). Median follow-up interval was 1337 days with a 91% follow-up rate at 2 years. AVR was performed in 886 patients (98%) in the symptomatic group and in 287 patients (99%) in the asymptomatic group. Symptomatic patients were older and more often had comorbidities than asymptomatic patients with similar echocardiographic AS severity. The cumulative 5-year incidences of all-cause death and heart failure (HF) hospitalization were significantly higher in symptomatic patients than in asymptomatic patients (25.6% vs. 15.4%, P=0.001, and 14.2% vs. 3.8%, P<0.001, respectively). On landmark analysis at 30 days after AVR, the differences in mortality and HF hospitalization between the 2 groups were mainly observed beyond 30 days. Conclusions:When managed with the initial AVR strategy, the long-term outcomes of symptomatic severe AS were worse than those of asymptomatic severe AS. Early AVR strategy might be recommended in some selected asymptomatic severe AS patients with reasonable operative risk. |
著作権等: | © 2017 THE JAPANESE CIRCULATION SOCIETY Publisher permitted to deposit this paper on this repository. |
URI: | http://hdl.handle.net/2433/244318 |
DOI(出版社版): | 10.1253/circj.CJ-16-0998 |
PubMed ID: | 28179592 |
出現コレクション: | 学術雑誌掲載論文等 |
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