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Title: Five-Year Clinical Outcome of Asymptomatic vs. Symptomatic Severe Aortic Stenosis After Aortic Valve Replacement
Authors: 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
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
Author's alias: 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
Keywords: Aortic stenosis
Aortic valve replacement
Outcome
Valvular disease
Issue Date: Apr-2017
Publisher: Japanese Circulation Society
Journal title: Circulation Journal
Volume: 81
Issue: 4
Start page: 485
End page: 494
Abstract: 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.
Rights: © 2017 THE JAPANESE CIRCULATION SOCIETY
Publisher permitted to deposit this paper on this repository.
URI: http://hdl.handle.net/2433/244318
DOI(Published Version): 10.1253/circj.CJ-16-0998
PubMed ID: 28179592
Appears in Collections:Journal Articles

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